Friday, March 27, 2009

This post is In Memory Of Andrew Callighan, who died 21 April (Saturday), two days after he was struck by a pickup truck while riding his bicycle in Michigan. Andrew, who was not wearing a helmet, was thrown several feet from his bike by the impact of the crash and was found on the side of the road when police and other rescue workers arrived. He sustained severe and multiple skull fracturesand was pronounced dead Saturday at Helen Devos Children's Hospital in Grand Rapids. Michigan has no state law regarding the use of bicycle helmets.

Get your coffee ready. We're going to explore 2 topics that I feel must be addressed. Each of those 2 topics involves a detailed case study (highlighted in blue font), and my comments are given below a table, or graph. My primary audience are the folks who use mis-information to suggest that helmets cause not only a decrease in cycling, but a host of other problems, some of which we will cover. I do not necessarily support mandatory helmet legislation, and don't give a damn about what is policy and what isn't. But I don't understand the logic of people who will use everything in their arsenal to fight law, if they are given the chance. I reckon at least 90% of these people would shut up if they had no 'mis-information', flawed or half baked research articles and spurious surveys to feed from in the first place. Helmets have their limitations, and I have no assumptions about them having super powers. While I do call for safety, what I'm calling for more is good research, accounting for alternative explanations, and applying caution and critical reading skills before believing in or spreading the material in research papers around.

Example : Mr. Burton, a transport planner, takes it upon himself to inform others that he read 'something' , somewhere that suggests helmets do zilch for safety.

* * *

INTRODUCTION

There's that saying that when your number comes by, its time to go. But the more stubborn of us are bound to challenge that and ask : "Really?"

Leaving out any religious connotations, I'm convinced by the fact that if you hold yours or someone else's life in your hands, and if you choose to rule out common sense and smart thinking in favor of stupidity or negligence, then its more likely that you or the other party is at higher priority on death's list. In this case, the 18 year old driver who handled the pickup probably made some poor driving judgments that took the life of the 12 year old boy, who also decided (or maybe even taught to do) that day that he would avoid wearing a helmet and take some risks.

On a third level are the noble folks who build structurally unsound products that don't function when they are called to do so. I have nothing to say to these people if they don't realize the damage they're doing, but hey...that's for another topic another day.

Over the years, the above 3 elements have finger pointed at each other whenever a traffic related issue came up. Drivers complain about stupid cyclists, cyclists complain about stupid drivers, and both of them complain about stupid cars, stupid bikes, stupid helmets and why, even stupid transportation laws and politicians. I am sorry to say that I'm ashamed of all three parties! Human tendency is to always hold self righteousness high and pass the soup bowl of blame to someone else, or provide an excuse for stupidity. If only one of the three could have done the right thing themselves, and followed the rules, or made life easier for the rest and lived and let lived, or did something like they said they would do, then we could be a more safe and constructive society.

Accidents can be avoided. Injuries can be prevented. Even wearing a helmet may not prevent the accident, but just like entering a lottery increases your odds of winning by a huge margin than your neighbor who didn't (probability of winning by not entering is a big zero), wearing a helmet increases the odds of preventing critical head injuries that could otherwise rob the quality of your life pretty quickly. [See Brain Injury Library, TBI Consulting]

1. STATISCULATION

The cabal of cyclists who don't support the wearing of helmets always have some excuse to make. Fine. If you don't like them, that's your choice. But by choosing to do so, you're agreeing to taking a huge risk with your critical 3 pound brain, your skin, your bones, the value of your life and that of your family's.

But there's one interesting thing here. To make their case loud and clear, they do some sketchy things. Among them is pulling up statistics from heaven knows where that show the growth of some negative events for cycling and attribute those events to some form of helmet law. The event can be anything from the decrease of cyclist numbers on the road to the increase in head injuries.

How they come up with this definitive correlation is not explained to the rest of us. What matters to them is that it correlated, somehow. Finally they come to the wonderful conclusion that helmet laws are indeed responsible for decreasing cycling. Or that helmets actually increase the rate of head injuries.

But for every explanation, there are alternative ways to think. For instance, in the first scenario, did wearing helmets really decrease cycling or did cyclists just stop riding, having found something better to do with their time and money? In the second scenario, did helmets increase the rate of head injury or did cyclists ride more faster (due to the false sense of security) and push the helmet they were wearing beyond design conditions for which it was made?

Oops. Didn't think of those, did you?

Sadly, in the age of the internet, we don't have too much of information anymore. We have too much of mis-information. Mis-information is spread by people who have more time to waste than the person willing to read and agree to them.

Be careful with statistics and spurious looking "graphs". At best, they can help understand a trend and simplify this complex world we live in. At worst, they can be employed by the person creating and using them to deliberately tie in two unrelated events and LIE. When they are presented to the rest of the world, the flu is passed around. Misleading people with the use of statistics is called Statisculation. The people most likely to be misled/awestruck are the ignorant who don't give a damn how statistics work or how the figures presented to them were arrived at. If they have a thought process to begin with that they absolutely stand by, and if they find any 'statistic' that will support that thought process, they will welcome it by all means and pass it onto others. [See How Statistics Can Lie, United States Golf Association]

CASE-STUDY : DID THE HELMET LEGISLATION REALLY DECREASE CYCLING IN AUSTRALIA AND LEAD TO OBESITY?

JACOBSEN'S FIRST FORMAL ANALYSIS OF THE SAFETY PRINCIPLE :In 2003, in a paper written for Injury Prevention, P L Jacobsen famously validated the "Safety In Numbers" principle, a well known concept in transport circles. The paper proved this principle by using census data to show that the likelihood of a collision between motorists and cyclists in many Californian cities decreased as the numbers of cyclists and pedestrians increased (inverse proportionality). This principle was represented by his exponential growth equation relating "relative risk of cycling" with the "amount of cycling". If cycling doubled, he said, the risk per km falls by 34% according to his exponential relationship. You can read the original paper here [Free, PDF].

D. ROBINSON'S RESEARCH TO VALIDATE JACOBSEN :On the other end of the globe in Australia, D. Robinson, a researcher from University of New England in New South Wales, tried to replicate and validate Jacobsen's safety principle. In 1990, a mandatory helmet law was passed in Australia, making it the first in the world to do so. Robinson sought to also find out if there was any correlation between the injury rates as reported by hospitals prior to and after 1990 (year of helmet law), compared with the number of cyclists on the road in the same time periods. She chose localized areas in Australia for this reporting, as opposed to several cities and communities that would make up the continent. You can read the original paper here [Free, PDF]

BEFORE THE HELMET LAW WAS PASSED : Robinson reported that cycling dramatically gained popularity in WA in the 1980's and as a result, cycling became more safer because the number of cyclists being admitted to hospitals decreased as per information from WA Health Department! Between 1982 and 1989, number of regular cyclists on the roads doubled. Take note that Robinson defines a "regular" cyclist as anyone who cycled at least once every week. The number of injuries and deaths per 10,000 cyclists decreased from 5.6 in 1982 to 3.8 in 1989, a 32.14% decrease. She rounded that to 33%, and finally concluded that it is consistent with Jacobsen's growth rule which states that if cycling ever doubles, the risk per km falls by 34%.

ESTIMATIONS WERE USED :Australia did not have data on bicycle use for these years. So Robinson used "estimates" that she borrowed from the Australian Bureau of Statistics for 1982, 1986 and 1989. The amount of error in these estimations are unknown and how they were estimated is also largely upto the guessing of the reader of the paper. If the estimations had error in them, we might as well find that the number of cyclists didn't increase, but they fluctuated or stayed somewhat constant in that time frame. In that case, the data wouldn't really validate the Jacobsen's growth principle for Australia or the rest of her theory that is to follow.

ROAD VEHICLE TREND? What gets cloudy here is that she does not show how the trend of motor vehicles on the road varied in this time frame. Suppose the number of motor vehicles decreased (due to population migration, motorists choosing biking instead of driving, or other reasons) then logically, that reason could also be attributed to the lesser number of fatal injuries in cyclists. No data of number of vehicles and the trends in their use during these years in WA has been provided to us.

AFTER THE HELMET LAW WAS PASSED :Robinson reported that certain "surveys" showed cycling had decreased in the years following the legislation year of 1990.The graph on the right side is extremely unreadable, as obtained from the original paper, so I've obtained a better one from a primary source that Robinson cited in her references. This primary source happens to be a 1995 paper from Monash University by Carr et. al which I will discuss a little below. You can access the paper here here [Free, PDF].

WHAT SURVEYS? :What the source "surveys" were, we not told explicitly. It is often assumed by many people that somehow surveys provide accurate information. But are they really scientific? How can you remove biases and the tendency to report wrong beliefs like we often see in surveys? What is the amount of error in these surveys? What is its confidence rate in %? Afterall, robots aren't behind surveys. Humans are. Also, if census data was used to distill the details of how much people were using their bicycle, the amount and frequency of data collection always has limitations. A census may take place infrequently (every 5 or 10 years) and it also may not yield comprehensive data about bicycle use by the population.

SMALL DATA SAMPLES : Even if the surveys were well documented and have 90% confidence , they reported on a small sample set for Melbourne, Victoria for the years 1987 to 1992. The number of years in that sample after the legislation was passed is a mere 2. It is not for the whole of Australia either. It is for Melbourne, Victoria. More importantly, the counting of cyclists was done in the same month (May) between 1990-92. What about the rest of months?Did the count decrease or increase? People may have different agendas from the May of one year compared to the May of the other year. Some may just be late to get on the bike due to being busy with other engagements. Robinson's data does not explore the cycling trend in those other months.

THE CYCLING TRENDS BETWEEN 1990-92: Now for years 1990-92, for the month of May, the decrease is not so dramatic as shown by Table 2. More cyclists were wearing helmets and the number of cyclists counted decreased in the first year and then rose again in the next if you check the numbers. Going by Robinson's numbers for adult cyclists, there was a 29% decrease change in cycling counts in 1991 from 1990, after the helmet legislation. However, in 1992, there was a 34% increase change in adult cycling counts from 1991. The levels had almost returned back to 1990 levels. Robinson doesn't delve into this too much, but still diverts the reader's attention to decrease in child cyclists and injuries.

DEDICATION OF CHILD CYCLISTS VS ADULT CYCLISTS :We all know that children are fickle minded. As they grow up, or due to some form or another of peer or parental pressure, their interests and hobbies and life goals change. Pretty darn quick. Children also could have been discouraged of cycling not because of helmet laws, but due to the fact that the helmets they were now required to wear by law were DORKY LOOKING, uncool, user unfriendly, or plain ugly to show around in public. I'm very much interested to see a sample helmet from 1990 in Australia and what kids thought about it THEN. Was there a survey of that?? Robinson does not go deep into this very important issue at all. But she's quick to take the naked numbers of decrease in child cyclists and point fingers at helmet laws. It is adult cyclists who are the dedicated ones. They have to go to work, and if that is to be done by riding a bike, they'll do it because they're the ones to put food on the table, not their kids. In the year following helmet law in 1990, according to table 2, the decrease in adult cyclists was lesser than the decrease in number of child cyclists compared to 1990 (-461 adult to -649 child, 1991) . In 1992, the increase in number of adult cyclists from 1991 was more than those of child cyclists (+378 adult to +89 child, 1992). As one can see, child cycling never recovered properly in that year compared to adult cycling. Robinson really didn't question this and find out WHY? She just quickly moves on to prove her big theory.

ROBINSON'S LOGIC :From the data in the table above, Robinson's logic is that the increases in numbers wearing helmets were "generally" less than decreases in numbers counted...which led her to write that this proves non-helmeted cyclists are more likely to be discouraged to wear helmets and continue cycling.

Wow. Wait a minute.

How can she relate 'discouragement' in Australian cycling with numbers for a small sample set of 30 days for 2 years for Melbourne, Victoria?? I can't understand that logic. Also, the more dedicated of cyclists are in the adult population, not in children. The decrease in child cyclists was more than that of adults.

SEASONAL VARIATIONS UNACCOUNTED FOR :The data also doesn't account for seasonal variations in cycling precisely because it investigated only the month of May. We all know that cycling is a seasonal activity. Only few are brave to venture out in winter in the elements. Victoria has a winter season.People ski there on its slopes, among other activities. Melbourne is colder than other mainland Australian state capital cities in the winter.More commonly, Melbourne experiences frost and fog in winter. Also looking at a climate chart from the Bureau of Meteorology, the month of May is one of the coldest in Melbourne, with temperatures ranging between a low of 9 deg C to a high of 17 deg C.

PRE-MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA (June, 1986 - June, 1994) :This comes from the Monash University citation that Robinson provided in her paper. The original data from hospitals for cyclist head injuries showed a decrease after 1990 but a sudden increase in 1993 and it was determined by "examiners" that this apparent increase was due to some "Casemix" anomaly in the Victorian Hospital System (increased admissions from hospitals because of the promise of more hospital funding from the government that year). So anyway, the original Hospital Admissions data for head injuries for cyclists was then modified through some sophisticated "multi-variate time-series modeling techniques" that even I have a hard time researching what they exactly did to the data. Anyone who didn't complete a sophisticated course in statistics can really bite the dust here.

MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA WITH MULTI-VARIATE TIME SERIES ANALYSIS :The modified graph after they applied their time-model to it just surprised me. Observe the lessened curve in helmeted cyclist head injuries after 1990 as shown by dotted line, compared to the solid lines that show the same before the model was applied. Again, the original data was modified through sophisticated statistical methods that only the researchers know exactly. Anyone has to seriously question the validity of these 'intervention analysis' techniques employed by different groups of researchers and understand it thoroughly before taking it, misplacing it and chanting slogans with it. At this point, I challenge all the people who decry the use of helmets : Do you fully understand these type of sophisticated statistical tools that researchers use to modify and play around with data? Do you understand the complex decisions that are behind these actions? Can you blindly say yes, before you've done your research and link to these articles to support your cause? A course in Time Series Analysis to fully understand what the Monash researchers have done in this paper requires atleast a semester or two of university-level study. This isn't the introductory level statistics that you do in your biology class.

The modified hospital data looked encouraging for cycling than the original. It was estimated from these modified data that in the first four years of helmet legislation, a 39.5% reduction in the number of head injuries was observed in Victoria(level shift). I presume that is what this graph shows. However, in comes at group of Australian researchers - Cameron et al, Mead et. al etc - who suggests that hey, the decrease in head injuries is dramatic compared to pre-law levels and then declare that this decrease MAY have been due an overall decrease in bicycle use, and not helmet use at all. Infact this has been suggested in Page 1 of the Monash report.

CONFLICTING RESEARCH CONCLUSIONS/SUGGESTIONS : Interestingly, in page 21 of the Monash report, there's evidence of some conflicting statements. They say their analysis is insufficient in distinguishing between reductions due to helmet wearing and reductions solely due to the possible reductions in exposure, and then boldly go on to say a little later that they think "its fair to assume" from their analysis that helmet legislation and the subsequent discouragement in cycling caused the decrease in head injuries that they "modeled" all this time. So what's the correct and final story on this one?

If you also didn't read between the lines of the report, page 15 says that the researchers didn't even investigate other measures of road safety in their models which may explain what happened to the decrease in head injuries to cyclists. How safe is this ignorance?

The rest of the paper from Robinson, which referenced the Monash paper for food, delves into injury rates for Victoria and finally concludes that : "Thus, as predicted by the growth rule, the risk of injuryper cyclist increased when cycling decreased because of helmetlaws in Australia."

Robinson's paper provides an inadequate picture of what really happened to cycling in the months after the helmet legislation in Australia. More so, one of the prominent references from Monash University she's given in her citation (Carr et al) use murky modeling techniques to modify original data, (which needs deep and further study). They also seem to be inadequate in their research as reported by themselves and make conflicting statements in several pages of their report, yet they say its "fair to assume" that helmet legislation decreased cycling numbers and hence cycling head injuries.

Robinson uses all this to do too much generalizing. She uses small sample sets, and data for localized regions in Australia (possibly from other researchers) to arrive at the grand conclusion that because the helmet law was passed in 1990, cycling collectively decreased in Australia in years thereafter! I may agree with the fact that there is safety in numbers but I cannot validate this paper to make a conclusion that helmet laws decreased cycling in Australia and dramatically increased the risk of injury just due to it. The trends for cycling that Robinson has reported is episodic and localized, and I would encourage her to investigate the effects of cycling over a long period of time and in many different places, at the same time, also delving into some of the other causes, apart from helmet law, that affected the numbers. I highlighted some of these possible causes in the writeup. It doesn't hurt to sometimes ask "WHY", even more than once.

Without giving a picture of all the factors mentioned above and their relative contributions to Australian cycling, no intelligent person reading Robinson's paper can accurately put faith in the fact that helmet law was the prime motivator for a long term, permanent, and nation wide cycling decrease in Australia. I urge her and the umpteen groups of researchers who have all fed on each other's research material to give these old papers a good second look. Continue to explore alternative explanations for a decrease in cycling levels. See if they are accurate, and still really relevant for 2009.

These are the papers that are being used to bring down safety laws in several countries of the world. I'm not even sure that the people who reference this material fully understand the use of your sophisticated statistical analysis techniques, and data manipulation tools and the implications of these actions.

PASS IT ON, BUDDY!

Many different websites, bloggers, forum participators and "medical experts" link directly to cycle-helmets.com, a website which makes it own interpretations based on Robinson and other Australian papers. Then they twist it to their liking and start throwing the bombs. Like this misinformation, portraying helmet laws as fighting with public health :

Most people who read this would not have read the original research papers but will assimilate other people's wrong interpretations of it and finally, what they'll receive, believe in and spread out to others are false assertions such as "helmets decrease cycling", or "helmets cause more injuries" or "helmets decrease public health" and so on and so forth.

If Australia has an obesity problem, does it really have to do a lot with "punishing" helmet laws or more to do with laziness of people (an age old problem, even before helmet laws), personality and psychological issues, and the human desire to put in more calories into the body than what is burnt. There is a definite science behind obesity and understanding it will help solve problems. Does the author of cycle-helmets really believe that there is some sort of major underworld partnership going on between obesity in Australia and bicycle helmet legislation?

Many other sections of cycle-helmets.com contain mis-information through videos. My favorite one was the following below, a link to a video showing a car running over a helmet, as if suggesting to the reader that a helmet should be somehow designed with super powers to withstand the weight and force of a car over your head.

Oh, and if it breaks, it must be a worthless piece of junk right?

Websites like cycle-helmets.com are easily visited by people because of its suggestive URL. Any one trying to do an internet search for cycle helmets will be caught unwary and visit the link. Then they'll be pulled into reading some fantastic BS on the drawbacks of helmets, helmet laws and how it brought down the entire continent of Australia and continues to do so.

Taking the example above of the "helmet laws & decreasing cyclists" correlation, it could very well be that the number of people cycling decreased because some of them discovered another sport and chose to commit to that over biking. I'm not saying that's exactly true, but what if it were? The question to ask then is : Is cycling the only way to keep fit?

If a person wants to be healthy and lead a better life, cycling is not the only avenue. If he got discouraged in cycling because of the need to wear helmets, he may not necessarily have gone back to drinking and smoking and sitting on the couch watching football all day. Unless you can prove that, this argument has no weight in it.

As cyclists, we all love to support our cause and make ridership grow. No harm in that. But healthy living comes in many forms. Bicycling is a solution. But its not THE solution. You can walk to work, golf, or play tennis on weekends, or even chill out in the swimming pool. Why the heck do you have to ride a bike to remain fit? Is it the only sport around? Please stop the desire to homogenize sporting and let people be themselves. Embrace your hobby and talk about it, but learn to shut up and let people do their own thing. Simple. Lately, pushing has come to shoving to make people ride more. I do not approve of this behavior, either from cyclists, advocates, or public health politicians. Promote all healthy ways of living, don't bias yourself to one.

CASE-STUDY : DOES LACK OF CYCLING SUDDENLY CAUSE DISEASE?

In a letter to the editor of the Canadian Family Physician, Thomas DeMarco MD argues that helmet legislation could decrease cycling. In his writeup, he references an Australian experiment with helmet law and connects it to the falling in ridership. We already covered the Australian Helmet Law crisis above and the flaws in a prominent research paper. But the citation given here is some 'C. Komanoff' who read 'some data' from a so-called 'Monash University' at some 'pro bike conference' in Ore, 1994. Great. What the heck is that 'data'? We won't know.

NO CYCLING = DISEASE ARGUMENT : In the following lines, he emphasizes that"most importantly, less cycling means less physical activity which translates to more atherosclerosis, obesity, non-insulin dependent diabetes mellitus and osteoporosis." Wow! Thats a big bunch of disease. How did Mr. DeMarco arrive exactly at the definitive correlation? No cycling = disease? And did he begin with the false thinking that cycling is the only sport, past time or recreation around, or that people who don't commit to cycling suddenly commit to physical inactivity in an instant, which inturn gets them sick and about to die? Can you please prove that?

IS CYCLING THE ONLY WAY TO STAY HEALTHY? What gives Thomas DeMarco the monopoly to generalize the human mind and the complex wants and desires of people? Or ignore other sports that can help one stay healthy? Most importantly, what gives cycling the monopoly to make people healthy? If this was the only way to be fit, we'd imagine a health fanatic world full of cyclists. That's not the case.

I, for one, am thankful that cycling is not the only sport/recreation around. I'd go beserk, otherwise.

CONCLUSION

The more I think about people complaining over helmets or helmet laws, the more I feel that they just care about the advance of their dogmas to others. They don't really care for their safety first and foremost. They don't think about the situation and environment they're cycling in (Europe is very different from America, where the status quo is motorship), and for them, the sport of cycling is the only salvation to a better life. If helmet laws are passed, they say that it will quickly bring down the numbers of cyclists on the road by quoting and data mining from questionable research articles and surveys done in other countries in different time periods. Then they argue that if ridership decreases, the number of people with AIDS, malaria, obesity, osteopororis, diabetes, blood pressure, cancer and any other ailment that you can think of will INCREASE. And we are to believe that.

False interpretations of statistics, or statisculation, and making absolutely baseless correlations between two unrelated events have been the defacto tools for these groups of people to fight helmet laws.

Yet, given all this, you oddballs may still opt to rule out helmets and decry the need for safety to ride the way you feel is best. Which is absolutely fine, as long as you don't mis-inform others, while forgetting the personal risks of going riding without a helmet.

But there could be a point when you arrive at the cross-roads. Say it was a Monday morning and you see your 12 year old kid, your own life and blood, walk out of the house with a bicycle. He's going to ride beside the road to get to school, which is about a mile away. He's not wearing a helmet. (At least that's what he learnt from the family growing up).

In a chilling moment a few hours later, the telephone rings at your house and the local cops have some life changing news for you and your wife. Its very distressing and there are no words to describe that sinking feeling. They happened to bring some really bad news about your son. He was riding his bike to school but apparently... he never made it there. They are requesting you at the scene immediately. Suddenly when your world was going all smoothly, someone in your family has become a statistic.

106 comments:

The graph in Dorothy L Robinson's paper you describe as "unreadable" comes from this report (Aug 1995) by Carr, Skalova and Cameron, which is referred to by Robinson -- http://www.monash.edu.au/muarc/reports/muarc076.pdf , where it is in a better resolution (page 21). You may be able to validate it and decide whether Robinson tampered with it.

I hate helmet wars. I used to wear a helmet on the road so that no scum-sucking bottom dweller lawyer could argue that "yes, my client's Hummer flattened your client like a bug, but your guy wasn't wearing a helmet."

When I was on a safe bike trail in the middle of nowhere, I'd skip the magic foam hat.

My riding partner did an endo on one of those rides on a perfectly clear stretch of blacktop trail on a perfectly clear day while not wearing a helmet.

ksteinhoff : My thoughts go exactly with yours in this matter. I said the same thing in the final paragraphs of my introduction, if you will read it once again. Milliseconds or microseconds, your life can change pretty damn quick with a brain injury. The delicate balance that is life then hangs on a loose thread and whether you live or not is upto sheer luck and to some extent, how much money you've got to pay the medical bills.

I don't wear a helmet to save me when I get creamed by a truck going 60. Pretty much nothing will. I wear it so when I flop over because I couldn't unclip I don't need to worry about cracking my head. I have clumsy moments too often and I like my brain.

I also believe in mandatory helmet laws. People have demonstrated they are too dim to protect themselves so someone needs to do it. Especially when their choices can have such a harsh impact on everyone else (40 years of long term care because they hit their head riding a bike, courtesy of medicare)

You've brought some hard, and excellent questions to light. It has got me thinking a lot. In this age of the internet and other popular types of media, other folks do our thinking for us, while we sit like zombies and assimilate all this information without any critical thinking on our part. Both the people who are behind spreading lies, and those who find it okay to believe in it are treading the wrong path. Sadly this isn't going to help cycling at all.

You forgot some more issue, which I thought may be helpful. Most of this data is outdated for our times. I'm not sure if a national helmet law still exists in Australia, but I'm very much interested to see the trend in cycling numbers since 1990-2008.

Cycling is one of those sports where you can get sucked into the Me of it a little too much. I train, I race, I win, I do/do not wear a helmet. If you're an orphan who isn't married and works the night shift at a morgue, then I'd say you're pretty safe with the me-factor. If you're married, have a son, are a daughter or a son then you have responsiblities whether you like it or not. Not being a burden on those who care for you is one of those repsonsibilities and if wearing a helmet assists you in that end, then wear it.

One of the big issues I have heard is that helmets decrease youth cycling because kids don't think they're cool.

My answer to that is that our industry has a huge number of talented and innovative people who can make kid's helmets look cool and hip. If they don't exists today in the market, they will tomorrow due to that need.

If kids were only educated enough and shown the consequences of head injuries and the life thereafter, they would equate a disabled life with UNCOOL and value safety more than 'looks'.

Interesting post. I find it hard to suffer fools gladly, both those who believe everything without question all that is on the 'net or elsewhere, and those who think rding without a helmet is OK. Helmets are cheap insurance for the umpredictable. I can tell you from experience, personal and otherwise that helmets work. As for believing all one is fed in *data*, there is plenty of evidence that bad data = bad results.

In my case there is no doubt that wearing a helmet covered my ass plenty when I crashed a few years ago. And this accident was on a well known bike path. Short story: Was riding along, minding my own line, when an idiot who was passing crashed into me. His flat h-bars went into my front wheel and my head into the ground. I had multiple broken bones, collapsed lung, etc (Was in the hospital for 6 days. The guy that caused this got back on his bike and rode off w/o so much as a "Oops - sorry!"). Other than a slight concusion my head was OK. After looking at the remains of the helmet the doctor stated that I would have suffered a fractured skull at the least, or death at the worst.

I *get* the whole "ride without a helmet" mistique. I must have trained 10k or more back in the day without a helmet and raced with a hairnet helmet. Hell, everyone did back then. And when the Fed made the use of hardshell helmets for racing the rule I was just as loud as anyone else in bitching over the change. I look back and laugh at how ignorant we were then. Now that helmets are light and well vented, one would be a fool to not wear a helmet, just as much as to beleive all the crap data on can easily mine on the internet.

1) Dramatic or vivid event X occurs (and is not in accord with the majority of the statistical evidence) .

2) Therefore events of type X are likely to occur.

Okay, let me straighten out a point.

In essence (in light of this fallacy you're talking about), are you saying that if you believed in not wearing helmets and suddenly your son died because of not wearing one, you'll still fight helmet wearing and decry using one. And you'll encourage more kids to do the same?

Australian State of Victoria made cycle helmets compulsory in 1990 and the following year the number of cyclists was apparently reduced. Nine years on, however, cycling is more popular in Victoria than it was before 1990. Cycle helmets have been accepted as a sensible safety measure much the same as motorcycle helmets and car seat belts.

For those concerned about the price: the price goes down dramatically after introduction. In Victoria a standard helmet now costs less than twenty Australian dollars (around eight pounds) and they come with several different thicknesses of exchangeable internal pads to accommodate growing heads and ensure an accurate fit.

They keep the rain off too which, as I recall, would be a useful attribute in the UK.

Just like the introduction of seat belts and motorcycle helmets, it started off feeling like just another piece of irrelevant bureaucratic madness. But nowadays as I flush out the coronaries up the hill to work, I feel naked without it.

Thanks for sharing, Ron. I like my brain, and though I don´t think a helmet would save my a$$ if I get crushed by a car, there´s a chance it´ll help me avoid catastrophic brain damage. I ride a lot, and experienced two head blows. None had major consequences, both times I was wearing a helmet.

On a similar vein, there are some ¨statisticulations¨ that claim that breast examination does not reduce mortality from mamary cancer. Maybe not in a ¨population¨, but effing A it make a lot of difference to the woman who managed to detect her tumors early.

It is hard to equate something that is in the population of hundreds of thousands (i.e. cyclists) with personal experiences. Undoubtedly many don´t like wearing helmets, and for some of them mandatory helmet laws will be a final disincentive to cycling. What can I say? Many people still refuse to wear seatbelts or keep using their communication devices to ¨text¨while driving. Laws have been put in place to protect them (and others), and reduce the cost to society of the risks they take.

I think Farrar and Raisin were happy to be wearing a helmet, and it wouldn´t have made it worse on Casartelli. But hey, it´s your head; if you don´t think it´s worth protecting who am I to convince you?

There is strong international evidence that the wearing of a bicycle helmet reduces the risk of being seriously injured in an accident by 60- 80%.

There is no empirical justification for saying that a compulsory helmet-wearing law reduces bicycling as a means of transportation. Experiences from Australia and New Zealand show that most people continue to cycle, using a helmet as protection, after legislation comes into force.

During a short period following legislation in Australia a slight decrease in bicycling among groups of teenagers and adults was detected, but there is no scientific evidence that this is a lasting effect.

This is a very good post. I pass on my condolences to the family of this boy. Even if a few lives can be saved with helmets, its a worth.

Rob : Thats what I've been trying to show. This widely reported decrease in cycling after helmet legislation in Australia was not dramatic and was highly episodic and highly location specific. Unfortunately, the data for Western Australia cycle usage are inadequate to support or disprove any hypothesis on the impact of compulsory helmet wearing.

"anyway, i'm always up for a laugh so feel free to tackle the other 40-50 odd helmet-sceptic papers when you're ready.

Jens"

This is hilarious. Not only did Jens not read the article, Jens also throws out "40-50 papers", but gives no references. I wonder Jens wants you to review them because he hasn't read them himself. As a trauma surgeon and cyclist, I can say helmets save lives, decrease disability, and save millions in medical bills. The skeptics are pathetic.

Wearing a helmet saved me from serious head injuries twice. That's all I need to know to believe it's a good idea.

I think a lot of people don't realize it has nothing to do with how good or careful a rider you are. It's the other guy, the one not paying attention while driving his 2-ton bullet, who's going to make you land on your head.

I won't bother addressing the nonsense in the text above, but as a target of one of your attacks I request you get just one thing right - the address of my website is www.cycle-helmets.com

Anybody with the ability or desire to see the damage caused by helmets in a mandatory jurisdiction should visit and browse.

And since the commentary above is all about opinions instead of facts, I urge readers of this page to question how (or why) the author can't even figure out the correct URL of a website being attacked... again, it's http://www.cycle-helmets.com

The author of this page might like to make my site address a link within his editorial so readers can more easily access the facts.

My apologies to the author for suggesting there was no link to my site ... I've realised there is already a correct link but the visible text spelling of the URL is wrong. It has a hyphen ... www.cycle-helmets.com.

Again, I urge readers to click to my site and thoroughly research the data, including government road surveys that confirm significant falls in cycling popularity when the helmet law was introduced in Western Australia.

Notwithstanding my oversight re the link and apology for suggesting otherwise, I repeat my point that this blog is opinionated nonsense.

First let me apologise for the poor quality of the graph in the Safety in Numbers paper – the publisher reduced its size and I didn’t notice that it had become unreadable. See http://www.cyclehelmets.org/papers/c2022.pdf for a clearer version.

The data in the graph have not been ‘manipulated’, but different scales were used (left hand axis for head injuries, right hand for other injuries) to make the pre-law lines roughly comparable. There is a clear seasonal effect, and a big drop in both head and non-head injuries when the helmet law was introduced.

The surveys of cyclists in Melbourne required 640 hours of observations per year, so I’m not surprised there was no attempt to investigate seasonal variation. However, year-to-year comparisons are still valid, because the surveys took place at the same time of year, and used the same sites and observation times, in similar weather.

The simplest way to find out if cyclists are deterred by helmet laws is to ask them. For example, in New South Wales, 51% of schoolchildren owning bikes, who hadn’t cycled in the past week, cited helmet restrictions, substantially more than the numbers citing other reasons, including safety (18%) and parents (20%). When I discuss the benefits of cycling with non-cyclists, I continue to be amazed at how many adults tell me the helmet law is a deterrent.

Australian census data on cycling to work (http://www.cyclehelmets.org/1194.html ) show steady increases in the proportion cycling to work until helmet laws were introduced. When split into states with and without an enforced helmet in 1991, the overall proportion decreases in the former, but continues upward in the latter. Coincidence? The subsequent decrease in the 1996 census (by which time these states had enforced laws) seems like one coincidence too many – it’s hard to imagine that helmet laws were not responsible.

It’s sad when people misuse statistics, even inadvertently, as in Adrian’s claim that “Victoria made cycle helmets compulsory in 1990 and the following year the number of cyclists was apparently reduced. Nine years on, however, cycling is more popular in Victoria than it was before 1990.” This is not true - in the 1981 and 1986 censuses, 1.79% and 1.75% of Victorians cycled to work; in 1996 and 2001 the proportion was 1.15% - cycling to work was not more popular then before the law.

I believe the claim Adrian cites was about a small inner city area where cycling increased after the roads were made more cycle friendly. The most likely explanation for the local increase (not reflected in state-wide census data) is that cyclists changed their routes to take advantage of the improvements in specific roads.

The increasing attention on the health problems of our sedentary lifestyle (and the effect of Peak Oil in sending prices back to their previous highs if we recover from the financial crisis) should encourage more people to cycle. But this does not mean helmet laws are not a deterrent. Without helmet laws, we might have had twice as people cycling as there are now.

Cyclists are exhorted to wear helmets by instilling fear about serious brain injury. But hospital studies show that most seriously debilitating brain injuries are caused by bike/motor vehicle collisions and involve forces many times greater than those for which helmets are designed. A far better way to reduce head injuries to cyclists is to make the roads safer. Figs 6, 7 and 8 of http://www.cyclehelmets.org/papers/c2022.pdf show large and obvious reductions in fatalities coinciding with the introduction of random breath testing, speed cameras and other road safety initiatives. The fact that we can see obvious reductions in fatalities coinciding with these initiatives, but not in the percentage of head injuries to cycling crash victims after the introduction of bicycle helmet laws, suggests that the former are much more effective than the latter.

This is particularly true because helmet laws reduce cycling and so reduce safety in numbers - not just in Australia. Here’s a quote about US helmet laws: http://ashe2008.abstractbook.org/presentations/642/“Over the past 15 years, 21 states have adopted laws requiring youths under a certain age (generally 16) to wear a helmet when riding a bicycle. Previous evaluation research finds that these laws significantly reduced youth bicycling fatalities, and the prevailing view is that fatalities fell because helmet use increased. In this paper we confirm that helmet laws reduced fatalities, but we uncover robust evidence of an alternative and unintended mechanism: helmet laws significantly reduced youth bicycling.” The author is an Assistant Professor of Economics/Public Policy at the University of California Irvine.

Children who don’t cycle are likely to grow into non-cycling adults, compounding the effect of reduced safety in numbers, again suggesting that helmet laws are bad policy. The graph at http://www.cyclehelmets.org shows that countries with the lowest helmet wearing rates have more cyclists and lower fatality rates per km cycled.

The only cycling head injury death I’ve personally encountered was a boy of similar age to Andrew Callighan. I wanted to encourage local cycling, and initiated a survey of what local cyclists considered difficult or dangerous. The location where the boy died was noted as problematical because cyclists’ view of traffic was blocked by parked cars, a fact we passed on to the local traffic authorities a year or two earlier. I gather from the autopsy that the boy’s helmet hit the windscreen, his head then rotated out of it, his brain started to bleed and the emergency operation was too late to stop the fatal build-up of pressure on his brain.

The protection afforded by helmets is limited. An article on ski helmets ( http://www.ski-injury.com/prevention/helmet ) notes that “In the 1998/99 part of the study, Shealy and colleagues followed the deaths as they happened and found that, where the information was available, 35% of individuals who died were wearing a helmet. This is much higher than the rate of helmet use amongst the general population on the piste.” The same is true for bicycle helmet wearing in Australia. Authorities do their best to record helmet wearing of cyclists in road crashes – for fatalities the proportion wearing helmets is greater than observed in contemporaneous surveys of population wearing rates. http://members.shaw.ca/jtubman/deadhelmet.html provides many examples where cyclists died despite wearing helmets.

The ski helmet article advises:"When you feel that rush of adrenalin while skiing (snowboarding), ask yourself if you would be doing what you are doing if you were not wearing a helmet. If the answer is NO, maybe you should reconsider the activity."

So if you find helmets comfortable and convenient, it may make sense to wear one, as long as it doesn’t encourage you to take more risks. But it’s also preferable to cycle without a helmet than not at all, especially cycling for transport, because there’s no evidence that people who give up utility cycling take up additional exercise in their leisure time. Mayer Hillman reported that the health benefits of cycling outweigh the risks by a factor of 20:1. A Danish study (Anderson et al., 2000. All-cause mortality associated with physical activity during leisure time, work, sports, and cycling to work) found that people who didn’t cycle to work had 40% higher mortality than those who did, even after adjusting for leisure time physical activity.

So if you find helmets comfortable and convenient, wear one. But don’t take any risks you wouldn’t take if you accidentally left the helmet behind. And remember that cycling without a helmet is far better for both health and our environment than not cycling at all.

I've become more skeptical of helmet effectiveness because of the injuries and deaths that have occurred to cyclists who were wearing helmets, rather than statistical arguments when entire populations have switched to helmet use.

At it's base, a helmet is made to absorb a certain amount of energy, but when there is death and serious injury to cyclists, collisions with motor vehicles are almost always involved and these collisions are far in excess of the amount of energy a helmet was made to absorb.

Even if there were such a thing as a helmet that was 100% effective, most cyclists would still die in collisions with motor vehicles because these collisions often damage other systems of the body to such a degree that death soon follows.

A helmet can provide a certain level of protection, but they usually can only offer protection from minor injury, rarely major injury. That people believe a simple helmet can save a life in a collision with a motor vehicle is sad because we owe others more consideration of what happens in the circumstances of such an incident and not rely on such a simplistic solution that no helmet manufacturer has ever been claimed to be within the protective qualities of their product.

As someone who has been closely affected by a loved one who died from a head injury I have to ask, what is it about riding a bicycle that brings up this issue? Does this happen to people on bicycles more than others, because I don't think it does.

The loved one I knew that died did so from falling down the stairs, not riding a bicycle. In my long life, i have also known others that have been hospitalized with head injuries from falls off ladders and automobile accidents as well. I paid attention when Dr. Atkins died from a head injury while walking on an icy sidewalk because I was on his diet at the time.

I don't understand why these head injuries seem to be getting ignored yet bicycle injuries get attention. I'm no scientist but I don't think it takes one to see there are far fewer of these injuries happening to people riding bikes than all those others.

In the memory of the one I loved, I would ask everybody to put this into perspective and not ignore the many and focus on a few. From the way I see this being played out around the neighborhood, no one seems to have any sense of perspective anymore. When I grew up, riding a bicycle was a good healthy thing to do and the only ones that ran into problems doing it were the ones who lacked a lick of common sense and probably would have had a similar problem doing something else because they lacked the common sense to behave safely in the first place.

Hey Ron, excellent post ! .. I liked your sentence "Human tendency is to always hold self righteousness high and pass the soup bowl of blame to someone else, or provide an excuse for stupidity"

Helmet use is also pretty up close and personal to me: 2 years ago My (then) 14yr old son & I enjoyed downhill, off road riding ( he dirt jumping, and me using it to test folding bike frames .. I know, but that's another story).

For this type of riding we both wear helmets - which saved my son's life. He face planted from a 15' jump , part of a set which he'd been regularly using for over a year. The 661 helmet did its job, and he survived.

At the time this outcome was not such a certainty - he was unconsious, sort of gurgling, in the middle of a forest. Fortunately within mobile phone range so we got help .. air ambulance to hospital. It took him 6 months to recover, like a PC booting from cold, from unconsciousness to 2, 6, 10 year old and eventually back to normal.

He still rides bikes to get about, but not for sport/leisure.

I grew up in the country .. we all rode bikes but never wore helmets, back then even car seat belts were not universal. So even now with my son's accident still raw, I only ware a helmet when riding off road or in traffic (eg across london).

I feel drawn to the cycling utopian cities like Amsterdam and Copenhagen where most short journeys are by bicycle, everyone wears their everyday clothes and no one wears helmets.

Telephone surveys showed people rode a lot less less, and people said in the surveys they rode less because of the helmet laws. You say "we don't know enough about those surveys." No proof, just your personal doubt.

Health experts say reducing riding will increase health problems. You say maybe people will exercise otherwise, by "chilling at the pool." No evidence they will, just your personal speculation.

More important, you understand no data at all! For example:

You imagine that every kid killed by a car would be alive with a helmet. How does an engineer not know that helmet test standards are completely blown away by car impacts? How did you not look at that data?

You act as if biking were a huge source of TBI. But it's not even on the map, compared to other causes! How did you not look up that data?

You act as if 20 years of helmet use had made biking safer, but it's had no effect, even where laws increased helmet use to 90% of bikers. How did you not look up that data?

Your screed boils down to saying "I, Ron, know hardly anything about this issue, but I've picked my side, and I'm going to write a blog."

That's the difference between bloggers and journalists. Bloggers have no editors to fire them for ignorance and incompetence.

You're an embarrassment to your profession. Not blogging - that's just a juvenile massaging his ego. You're an embarrassment to engineers.

Personally I am against compulsory helmet laws, but at the same time I would love to see more people wear helmets.

Making helmets compulsory is easy for legislators, it is far far easier to pass a law than actually find the money to create space on the roads and between the roads where cyclists can safely travel; helmet manufacturers and sellers no doubt love it too.

I am quite prepared to believe that helmets can help reduce the severity of some head injuries, but from personal experience I also feel that they hinder your ability to fall well. I have fallen off my bike a LOT, riding mountainbikes and BMXs for 30 years I have been over the bars many many times, I have been hit by cars on at least 3 occasions that have written off most of the bike, and I have lightly concussed myself once or twice (never on the public road). The reason that I have never had a serious head injury is not solely because I was lucky, but because I know how to fall, to put my shoulder in and tuck my head, enlarging the size of my head with a helmet makes me worry about limiting this ability and these are factors that you cant easily measure or analyse. Sure for the majority of riders, who do not have experience of falling, a helmet might be a good idea, but that doesnt justify hysterical legislation.

I occasionally take my 2 year old daughter out on a child seat, and I ALWAYS put a helmet on her, and she hates it, she kicks and screams while I am putting it on until I can distract her by setting off, and I KNOW that as a result I dont take her out as often as I would otherwise.

THIS is the problem.

Given that this is a blog (which I recently discovered and am much enjoying) with an ENGINEERING approach, then surely you should be advocating improvements in helmet design and materials to make them more pleasant to wear, easier to "fit", and more secure and effective, that will persuade people on the MERITS to adopt their use, rather than looking to legislation to FORCE their use?

Air bags in cars add protection without any detriment to passenger comfort, if helmets could offer similar protection without discomfort then it would be a clear cut case. But the bottom line is that Helmets are uncomfortable, in cold climates it is hard to keep warm and in any weather the chin stap is annoying. Personally I dont give a rat's arse what they look like, but the pleasure of cycling is severely compromised by the feel...

I'll speak up here and say I ride a bike without a helmet. Am I taking a risk? I suppose so but I think I'm not taking any greater risk than anyone else. I know who is taking a bigger risk than a cyclist who doesn't wear a helmet. Someone who isn't getting the exercise that a cyclist gets from riding a bike.

I'm at that age where health problems are getting bigger than problems arising from accidents. If someone is going to suggest a 50 year old man is running the same risk as a 12 year old boy, they might want to get their own head examined.

I know of too many people close to my age that have had a stroke or other malady that had the person been riding a bike, they may have avoided. Sometimes people can't see the forest for the trees.

You're an engineer? If so, you're an embarrassment to your profession.

Starting off with a personal attack? :) Okay, I'll get to this later. Lets see first what you have to offer.

Robinson showed electronic and observer counts demonstrated sudden big drops in cycling exactly when helmet laws appeared. You say, in effect, "maybe something else caused them." No proof, just your personal doubt. Telephone surveys showed people rode a lot less less, and people said in the surveys they rode less because of the helmet laws. You say "we don't know enough about those surveys." No proof, just your personal doubt.

Robinson reports in several places that she used census data and 'surveys'. I'm not sure where you're pulling up 'telephone surveys' from when I didn't find a single word saying 'telephone' in her article.

Anyway, I would have appreciated if she threw us an comprehensive appendix with the original census data and surveys she used for her conclusions. There is none, unfortunately. Hence, we can never exactly tell what the error % and confidence rate of all this big chunk of data was, without doing a statistical, regression analysis. Moreoever, as an engineer, I have been trained (or trained myself) to think outside the box and know that there is no ONE SINGLE answer to a problem. Alternative explanations could be always present. You want me to show you proof. How convenient. If I had the original data in my hand, and if I were in Australia at that time, it might have been much much simpler that task. Robinson is the one credited with writing this paper though. This is the report that said helmet legislation supposedly brought the whole of Australia down. Did she take the trouble to explore alternative explanations for the decrease in cycling numbers? No. But she's quick to stamp the reason for the decrease on helmet laws. I'm sorry, but this report is not a complete picture and I will not put my faith in it.

If you also read Robinson's paper, she reports census data for Australia as showing that the proportion of journeys to work by bike increased from 1.11% (1976) to 1.63% (1986). Think about that. In 10 years, that proportion in 1976 increased by just 0.52%. In the 1996 census, only 1.19% of journeys were by bike. Robinson doesn't give us the proportions for 1990-1995, but gives it for 1996, whose level came down sure, but it is still higher than the proportion of people biking to work in 1976! Now, can you still conclude that in 1991 or just immediately in the months following the law in 1990, there was a 'SUDDEN' decrease in cycling to work? Without adequate data, there is no way you can claim that the decrease in cycling to work was 'SUDDEN' and then paint a sorry picture for Australian cycling, or atleast for the 'commuting to work by bike' part of the story.

In Robinson's table 2, for adult cyclists, the % decrease change in cycling counts in 1991 from 1990 (legislation year) was 29%. However, in 1992, there was a 34% increase in adult cycling counts from 1991. The levels had almost returned back to 1990 levels. Robinson doesn't delve into this too much, but still diverts the reader's attention to decrease in child cyclists and injuries.

I love children and love to see them cycling as well. But we all know that children are fickle minded. As they grow up, or due to some form or another of peer or parental pressure, their interests and hobbies and life goals change. Pretty darn quick. Children could have very well been discourged of cycling not because of helmet laws, but the helmets that they were now required to wear by LAW WAS DORKY LOOKING, uncool, user unfriendly, or plain ugly to show around in public. I'm very much interested to see a sample helmet from 1990 and what kids thought about it THEN. However, Robinson does not go deep into this very important issue at all. But she's quick to take the naked numbers of decrease in child cyclists and point fingers at helmet laws.

Let me tell you one thing. It is adult cyclists who are the dedicated ones. They have to go to work, and if that is to be done by riding a bike, they'll do it because they're the ones to put food on the table, not their kids. In the year following helmet law in 1990, according to table 2, the decrease in adult cyclists was lesser than the decrease in number of child cyclists compared to 1990 (-461 adult to -649 child, 1991) . In 1992, the increase in number of adult cyclists from 1991 was more than those of child cyclists (+378 adult to +89 child, 1992). Just take a look at that for yourself. The decrease change was huge in child cyclists.

Did Robinson ever think that children have their own needs, their own personalities, and their own reasons to stop cycling compared to adults? Did she dig deeper into that issue? No. She makes the mistake of putting all this hotchbotch of numbers into one big number a.k.a "ALL CYCLISTS" and then shows how cycling decreased in Melbourne, Victoria in the mere 2 years following helmet laws. Where is the rest of the data for 1990-2005 or 2008? Where is the rest of the data for every single city and region in Australia. No clue. What is the long term permanent effect of helmet law? How can we know? Robinson gives us none. Inspite of all these drawbacks, she's quick to conclude that cycling collectively decreased in Australia following helmet legislation and that the continent is in dire straits due to it.

For people like you, you're quick to believe numbers but don't see how it can be deceptive if you don't apply a little bit of critical thinking to the numbers you read.

Health experts say reducing riding will increase health problems. You say maybe people will exercise otherwise, by "chilling at the pool." No evidence they will, just your personal speculation.

Apply this to your own self. If cycling were too expensive for you, and if some law intervened such that it would discourage you from your cycling, would you really be that shaken to go home, and sit and cry about it, while wasting away your life as a solution to it, by committing to a life of inactivity? If you said yes, you need to visit a psychologist. There's something wrong with they way you approach life and life's challenges.

In this day and age, to keep healthy, there are various means. Some form of exercises such as running require very little in terms of finance and the time to do. If people want to remain healthy, they will find a way. Human beings are not zombies like you may consider them to be.

Did Robinson delve into the issue of decreasing cycling numbers and wonder if they were COST related? What if it was helmets that were costly at that time, and people just didn't want to spend money for it? Can you then accurately say that these people who were frugal were discouraged by LAW, and not discouraged by the fact that they had to shell some money?

Lastly, some of these "health experts" that you talk of are highly specialized in their own medical field, but they have no specialization in investigating helmet laws and its effects on cycling. Hence, what they do to prove their point is link to or reference other people's work in this area. One of those works that have been referenced time and time again is Robinson's paper. Not one of them question it. They blindly believe it. Just because they're an expert doesn't mean they're intelligent. Even people with Harvard degrees commit the most stupid mistakes. Refer to the most popular management 'guru' books. You'll know what I mean. Reading most of them makes me want to throw them in the trash.

You imagine that every kid killed by a car would be alive with a helmet. How does an engineer not know that helmet test standards are completely blown away by car impacts? How did you not look at that data?

You are creating my imaginations for me. No where in my writeup did I say that : That I believe or "imagine" every kid with a helmet is alive today. Its about probability and cheap insurance, and a certain bit of luck. Please read the introduction to my writeup again on my comments on what a helmet affords you. I have no mis-assumptions about what a helmet does. It DOES NOT give you superpowers. IT DOES NOT promise to save your life. What it can do is reduce the PROBABLITY of head trauma (often by a considerable amount), and other critical injuries from a violent force. Your brain is what gives you your sense of self and ego and helps provide the motive force for all the functioning of the different parts of your body. Physically challenged people live, for one reason. They have the will to go on, and maintain their sense of self and attitude among others, and they have their brains, without which there is no will and no sense of self to begin with. Even if you can reduce the force of impact to your brain and subvert what may otherwise be lethal, that can prevent the quality of your life from going down the toilet. Sometimes, ending your life completely.

One more thing about helmet testing - Helmet testing does not seek to precisely reproduce real life situations, rather it attempts to define a set of requirements that is analogous to the types of situations that might be encountered while engaged in a prescribed activity. Helmet tests are designed to be repeatable, measurable and include a fixed range of situations a helmet might reasonably encounter. At this point the concerns of helmet testing does not include responses of the neck or body as they react with the head during a crash.

How a car interacts with your body and how your body reacts after is collision is many. The scenarios are numerous. Can a helmet assure you against all these permutations of collisions? No. Which businessman making helmets in his right mind would want to do that?

But what helmet manufacturers and certification underwriters can do is re-read the standards again and see if there's a place for revision, taking the latest research into account. If you've been following the recent news, this is already taking place in Canada with alpine skiing helmets, after a recent skiing tragedy of a a hollywood actress. Read the news.

You act as if biking were a huge source of TBI. But it's not even on the map, compared to other causes! How did you not look up that data?

TBI informs about the brain, why its critical and talks about brain injuries and what they can do to your life as a whole. Whether you fall from your bike, or get hit by an incoming freight train, its the brain that suffers. You want more data? Sure. That data is in many places. If you wanted, you could have retrieved and studied it. But you want me to do your homework for you. Saying "go bring the data" is a very popular way on the web for people to leave themselves out from doing work and producing intelligent discussions. I will not fall into this, but if I find I'm lacking data, I will go in search of it. I don't need your constant re-assurance, thanks.

You act as if 20 years of helmet use had made biking safer, but it's had no effect, even where laws increased helmet use to 90% of bikers. How did you not look up that data?

You have given me a personality of you own choosing, like I said before. Wow!!!! Did I really believe 20 years of helmet use made biking safer? Incredible. Did you see any quote of mine, in this post, or anywhere else in my blog from the 4 years that I've been writing, that made me say so???? Yeah, please... I'm going to have tell you : "DID YOU NOT LOOK THAT UP?"

Your screed boils down to saying "I, Ron, know hardly anything about this issue, but I've picked my side, and I'm going to write a blog."

Reading all your comments, I wonder if the same can be said for you. Your 'screed' to me is more deserted and vacant in data and conclusions than mine, or Robinson's for that matter.

That's the difference between bloggers and journalists. Bloggers have no editors to fire them for ignorance and incompetence. You're an embarrassment to your profession. Not blogging - that's just a juvenile massaging his ego. You're an embarrassment to engineers.

And what is your "competence", may I ask. Do you write for National Geographic, or the British Medical Journal, or the Time Magazine? Do you own the Sunday Times? Are you a Professional Engineer? Are you a lawyer? Or are you some sitting duck in a public library, with nothing better to do with your time? Who are you anyway, unwilling to stand and be counted with your words? Do you walk around with Ray ban's in public and drive a vehicle with blackened windows for anonymity?

You attacked me several times for my lack of 'data' and my personal convictions, and my profession. Yet, you bring ZERO to the table for an intelligent discussion. I don't even know who you are or your credentials. You may even be a disgrace to your profession.

Mark, I'm surprised you had the time to read my post, so a big thank you to that.

Like you, I do not support a mandatory helmet law. And like you, one has to use common sense and judgment to know WHEN to use a helmet. But do kids have that experience to judge when to and when not to? Thats why I plead with parents. Teach your kids. Even if you don't wear a helmet, that life who's times younger to you doesn't really know or have the same experiences as you to know WHAT WORKS and WHAT DOESN'T.

If we lived in an ideal, utopian world where everyone biked, maybe we could do away with helmets. But if that utopian world consisted of large traffic of cyclists, or alpine mountain passes where high speeds are incurred, then taking the helmet with you is insurance.

Blogs, which are mostly written by amateurs, couldn't possibly do what We Do (WE = News Media). Instead, they mostly just comment on what we do, supplying low-value-add chatter about our stories that must not be confused with Proper Journalism or other Quality Content from us Professionals.

The low cost of publishing a blog means that it is viable for a blogger to cover obscure niche subjects to a level of detail that would be economically unviable for traditional mass-market publications, which have scarce space and must attract a huge audiences in order to make money. Many blogs are not covering their subjects better than journalists working in mainstream media — they are covering topics that mainstream media are not covering at all. Why? Simply because, like you said, there's always that possibility that you can get fired tomorrow.

I believe in freedom of speech. I also think I have the capability to know which blog is good from which is bad. I have been reading this blog for a year and a half, and while I won't go on to say that I agree with everything...the Bee has his niche and no one is bold enough to strike up topics like he does. It makes for interesting discussions. And blogs do exactly that. They strike up conversations.

Blogs have their place, and print media have their place. Some bloggers are journalists as well. NYT has its own blog, if you didn't notice.

If you think blogs and print media are mutually exclusive of one another, you're not right, Sir.

Its interesting to see that from her primary comment to this blog, Dorothy Robinson also believes in Peak Oil Theory. While it is true that the age of cheap oil is coming to a close, no conclusive evidence exists today for the existence of a peak oil theory. If you're basing your theory on the price of oil, know that oil companies create artifical scarcity from time to time to bump up margins. The cost of pumping out a barrel of oil is also far removed today from classic supply and demand. Price of oil is determined today more by energy and futures trading markets than anything else.

Peak Oil has been debunked time and time again by several oil industry experts. I wonder what other mythology you believe in - how about UFO's??

The bullshit contained in research studies can only be extracted by someone who wants to take the trouble to. I'm sick and tired of research studies coming in the way of my life. All fucking research studies aim to do one thing - to cause depression and make you do stupid things. Research studies say I can't drink too much coffee, that I can't drink too much water, that I can't bike without hurting my sperm count (remember that one) that I can't swim without causing hair LOSS and baldness, that I can't eat fish because it will cause memory loss and stroke in old age.

The latest "research" scare comes with some Iranian fellow having found that drinking hot tea causes cancer! http://uk.reuters.com/article/healthNews/idUKTRE52Q01620090327?pageNumber=1&virtualBrandChannel=0 Me and me extended family members have been drinking tea for several years, yet we have no damn cancer sticking out of our mouths.

I am done with reading research studies!! They cause depression and sink the value and variety of life. The people behind research are nothing but fat assed lab rats. Get out of the lab and enjoy the world, people.

I was in a major bike stack 6 years ago with helmet.....helmet had major damage to L side and I had broken clavicle on L side....I ended up with a bleed in the brain R side, which is a contracoup injury as the brain bounces inside the cavity (known as your head).....would it have been worse ahd I not had a helmet on I dont know....but I am thankful I was wearing the helmet and it took the impact and my actual skull stayed intact.......

I work as a paramedic and only yesterday a crew from my branch attended a horse rider who came off a horse with no helmet and sustained fractured skull and pts head was split - skin folds opened up to show the skull about 6 inches in total of lacerations to the head...

From what I see in my job, wearing a proper fitting helmet is a "no brainer".

So should it be law? If the arguments against helmets include "I don't like wearing one" and "I should be allowed to choose" and the classic, "helmets don't look cool" people need to see what can happen if you don't wear one and one of those "it couldn't happen to me" accidents happen.

Chris Gillham said : "I won't bother addressing the nonsense in the text above, but as a target of one of your attacks I request you get just one thing right - the address of my website is www.cycle-helmets.com."

Chris, I understand you're the one behind cycle-helmets. Having read atleast 25% of your website, I think I'm done with your spreading of information that helmets do nothing for safety. But you're just that. An information spreader. What is your educational background to fully understand the statistical methods that the researchers have used, to put your complete faith in them? Do you understand science? Biology? Probability?

Can you explain how they arrived at the numbers to some of us?

I don't think you can. What matters to you is their conclusions. Not the mathematical steps that led them to believe so.

You need not read my 'non-sense'. I have challenged you to answer some of the detailed questions I have posed from reading some of the papers you referenced. They're not easy to answer, I don't think you can. You will think hard for sure though.

Spokejunky said : "Cycling is one of those sports where you can get sucked into the Me of it a little too much. I train, I race, I win, I do/do not wear a helmet. If you're an orphan who isn't married and works the night shift at a morgue, then I'd say you're pretty safe with the me-factor. If you're married, have a son, are a daughter or a son then you have responsiblities whether you like it or not. Not being a burden on those who care for you is one of those repsonsibilities and if wearing a helmet assists you in that end, then wear it."

Spoke, thats a good perspective and it puts people to thought. I always wonder whether the "no-helmet" group of people have families. And if they promote cycling to their kids, do they ask them to drop the helmet? I'm curious how they travel in their cars, or fly in airplanes? Do they scream at the law and shun seatbelts too?

The cost of taking care of a brain injured individual to society is huge. In Canada atleast, healthcare is funded by the public and they have to put laws in place to protect the system. Should the public as taxpayers bear the brunt of having to put millions to "take care" of few mentally challenged people, because they ignored their safety out of their own choosing and injured themselves while cycling when they knew that it could be prevented?

My ending paragraphs to my long post contain a thought for the day, regarding a child and a parent. No one has commented on it, save for one anonymous poster who accused me of some "MISLEADING VIVIDNESS" fallacy. Gawd...

Anonymous said 8:12AM : As someone who has been closely affected by a loved one who died from a head injury I have to ask, what is it about riding a bicycle that brings up this issue? Does this happen to people on bicycles more than others, because I don't think it does.

However, by no means does that mean cycling takes prime importance safety wise.

Consider any well reputed manufacturing facility in the United States there. Workers who handle machinery, folklifts, sharp objects etc are required by internal company codes to wear hard hats, safety glasses, steel toe boots and gloves. The company does it for their safety, and they keep safety a number one concern so as to avoid injury rates, negative press, and slowed down business because of incidences at their plants. Yet incidents do happen but they are considerably smaller than if the workers had been displaying unsafe working practices. The people down at the floor getting their hands dirty know how dangerous their jobs can be, so they don't form "lobbies" and complain company wide about safety rules. Besides, they also know they can get fired.

Sometimes, laws are good. It keeps people in check. Sadly, in cycling, we need "laws" to actually teach people "sensibility". If that saves a few lives, so be it...

Buttsy said : "I work as a paramedic and only yesterday a crew from my branch attended a horse rider who came off a horse with no helmet and sustained fractured skull and pts head was split - skin folds opened up to show the skull about 6 inches in total of lacerations to the head...

From what I see in my job, wearing a proper fitting helmet is a "no brainer". So should it be law? If the arguments against helmets include "I don't like wearing one" and "I should be allowed to choose" and the classic, "helmets don't look cool" people need to see what can happen if you don't wear one and one of those "it couldn't happen to me" accidents happen.

Thanks for reading and commenting. The picture you gave us of the injured jockey was so vivid, I just had to say 'ouch'. I think its people like you that we need more. People within healthcare who see these incidents first hand and show how their severity could be reduced if the victim had just done one thing - protect themselves.

Well written and it brings food for thought. Real science is not inventing a theory, putting some numbers together that will support it and then shove it down people's throats.

Real science is looking if your theory works, trying to invalidate it through alternative explanations and scenarios that will make it unshakable.

I quote Richard Feyman who said something elegant in this regard :

It's a kind of scientific integrity, a principle of scientific thought that corresponds to a kind ofutter honesty--a kind of leaning over backwards. For example, ifyou're doing an experiment, you should report everything that youthink might make it invalid--not only what you think is right aboutit: other causes that could possibly explain your results; andthings you thought of that you've eliminated by some otherexperiment, and how they worked--to make sure the other fellow can tell they have been eliminated.

Details that could throw doubt on your interpretation must begiven, if you know them. You must do the best you can--if you knowanything at all wrong, or possibly wrong--to explain it. If youmake a theory, for example, and advertise it, or put it out, thenyou must also put down all the facts that disagree with it, as well as those that agree with it. There is also a more subtle problem. When you have put a lot of ideas together to make an elaborate theory, you want to make sure, when explaining what it fits, that those things it fits are not just the things that gave you the idea for the theory; but that the finished theory makes something else come out right, in addition.

In summary, the idea is to try to give all of the information tohelp others to judge the value of your contribution; not just theinformation that leads to judgment in one particular direction oranother."

Ron questions the role of helmet laws in discouraging cycling. A list of 7 datasets showing reductions in cycling because of helmet laws, including 3 surveys where people were asked whether they had given up cycling because of helmet laws, is provided as an appendix to this post, along with references to several other studies.

These 7 studies, plus the other data cited in the references, leave me in no doubt that helmet laws discourage cycling. Most studies concentrate on the reduction in current cycling, but it seems likely that laws have an even greater impact on potential future cyclists – people who might like to cycle, but get put off by having the sweat pour into their eyes when they exert themselves. Newbie cyclists might also try riding to the shops, then (not having anywhere to store the helmet when they park the bike) end up inconvenienced by having to carry it around.

The drop in non-head injuries (dotted line in the graph “PRE-MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA (June, 1986 - June, 1994)” in Ron's blog is also relevant. What else could have caused a drop in non-head injuries, coinciding exactly with the start of the helmet law, except a drop in cycling?

“Research” claiming large benefits of helmets is almost all “statisticulation” – obtained by comparing groups of (generally safety-conscious) cyclists who chose to wear helmets with groups of non-wearers. Such studies report many differences between wearers and non-wearers – helmet wearers were more often seen riding on bike paths and parks, were more often white than other races, more often accompanied by other cyclists, more likely to use obey traffic regulations, and also use other safety equipment such as lights at night. After “statistically adjusting” for some of these differences, helmet-law proponents claim large benefits of helmets.

The problem is that the same statistical techniques were used to “prove” that hormone replacement therapy (HRT) halved the risk of heart disease. Women who chose to take HRT tended to be more health-conscious and have better diets and exercise. It turned out that this, not HRT, was the real reason why they had less heart disease. We learned this because better quality studies were conducted assigning volunteers at random to HRT and non-HRT groups, then studying the incidence of heart disease in both groups over the next several years. For more information see: http://ije.oxfordjournals.org/cgi/content/full/33/3/461

Because of ethical difficulties (and a much lower risk of getting a head injury than heart disease) there are no studies assigning volunteer cyclists randomly to helmet and non-helmet groups. The best we can do is compare percentages of hospital admissions with and without head injuries before and after helmet laws forced millions of cyclists to wear helmets.

In five jurisdictions where hospital admissions data were available, percent helmet wearing increased (within a few months of legislation) from a pre-law average of 35% to a post-law average of 84%. If helmets were even half as effective as claimed, there should have been an obvious reduction in the percentage of cyclist hospital admissions involving head injury. Unfortunately, this was not the case - see the BMJ paper: http://home.mysoul.com.au/dande1/bks/Robinson_06_BMJ.pdf

Studies of helmet laws don’t provide information on whether individuals should or should not choose to wear a helmet, only whether helmet laws are sensible policy. As Ron points out, mandatory helmet wearing may have encouraged cyclists to ride faster (due to the false sense of security) pushing helmets beyond design conditions for which they were made. If enough cyclists do this and so the head injury rate remains the same (and the non-head injury rate increases), the law was counter-productive, even if helmets are beneficial.

Robinson’s ‘Safety in Numbers’ paper didn’t dwell on the reduction in cycling with helmet laws because much of the data has been published elsewhere (e.g. http://home.mysoul.com.au/dande1/bks/AAP1996_Robinson_HI_hel_laws.pdf ) Instead it attempted to answer the more difficult question - whether reduced safety in numbers was more important for cyclist safety than increased helmet wearing from helmet laws.

The answer, as far as I can see, is that accident rates per cyclist did indeed appear to increase, consistent with the effect of reduced Safety in Numbers, implying that helmet laws are indeed counter-productive.

So what should cyclists do?1) Decide for themselves whether they, and their family, wish to wear helmets, but be careful not to expect a helmet will save their lives. Cyclists who wouldn’t ride a route without a helmet, probably shouldn’t ride it wearing one. 2) Fight helmet laws. The large reduction in non-head injuries in the ““PRE-MODIFIED 8 YEAR HOSPITAL ADMISSIONS DATA” is difficult to explain, except as a reduction in cycling, that lasted for the entire post-law period shown on the graph. What do you see when you look at that graph? A much greater reduction in head injuries, compared to non-head injuries would imply that the main effect of the law was to reduce head injuries not discourage cycling. Similar reductions in both head and non-head injuries imply that the main effect of the law was to discourage cycling, since the only way helmet laws can prevent non-head injuries is by discouraging cycling. 3) Campaign for improved road safety nationally. I’d much prefer to be hit by a car at 20 km/hr while not wearing a helmet than wearing a helmet and hit by one at 30 km/hr. http://www.cyclehelmets.org/papers/c2022.pdf shows many successful road safety measures with large and obvious responses in reduced fatality and injury rates, compared to the lack of obvious effect for helmet laws. Cyclists should campaign for the measures that have the greatest benefit.4) Do the same locally – report dangerous road conditions and nag the authorities until they are fixed. Getting dangerous conditions fixed might save your life by preventing an accident. Two benefit-cost studies of helmet laws were carried out – both show that if the money spent on helmets had instead been paid into a fund to fix dangerous road conditions, many more lives would have been saved.

Appendix – brief description of a few dataset showing the effect of helmet laws on cycle use:1) Monash University studies of 64 sites pre-law in May 1990, post-law in May 1991 and 1992. Although there was an increase from 1991 to 1992, a footnote explains that the 1992 data were distorted by a bicycle rally passed through one of the sites, where 451 cyclists were counted in 1992 compared to 72 in 1991.

2) comprehensive surveys of child cyclists at 122 sites covering Sydney, regional and rural areas of NSW. Before the law, 1910 children were observed wearing helmets. In the first and second years of the law 1019 and 569 more children were observed wearing helmets, but 2215 (36%) and 2658 (44%) fewer child cyclists were counted (Table 2, of http://www.cyclehelmets.org/papers/c2022.pdf .

3) Survey of schoolchildren in New South Wales: 51% of schoolchildren owning bikes, who hadn’t cycled in the past week, cited helmet restrictions, substantially more than the numbers citing other reasons, including safety (18%) and parents (20%).

4) A street survey in the Northern Territory: 20% of cyclists had given up because of the law and 42% said they had reduced their cycling (Mead 1993).

5) Automatic counters installed on two key cyclist bridges over the Swan river in Western Australia recorded an average of 16,326 cycle movements weekly for the three months October to December 1991 (pre law). The same months in the post law years 1992-94 recorded 13067, 12470 and 10701 cyclist movements per week.

6) A telephone survey in Western Australia, in which adults responded on behalf of themselves and their children found 13% of Perth and 8% of country cyclists had given up or cycled less because of the law (Heathcote and Maisey 1994). When the adult respondents in the telephone survey replied for themselves an estimated 27% of the State's adult population - cyclists and non cyclists - (the equivalent of 64% of current adult cyclists) would cycle more if not legally required to wear a helmet.

Ron, you examine the faulty statistics behind the Australian bike reduction numbers but accept without question the "60 - 80%" risk reduction rate noted by Ekman? Have you looked at the infamous Seattle study that the oft-quoted 88% number comes from? How about the more recent Austin study that made exactly the same mistakes in methodology?

How Ekman's "Even if a few lives can be saved with helmets, its a worth"? We have something like 16,000 head injury deaths every year in the United States from people inside of motor vehicles and tens of thousands more who become human vegetables, so where's your passion for protecting the children inside of the car? Even if a few lives can be saved, helmets on motorists and their passengers would be worthwhile, and 16,000 lives is more than few. These fatalities and injuries occur even with other advanced passenger protection inside the vehicle.

If you tell me helmets for kids in cars is ridiculous, may I then insult you with ridiculously baseless ad hominem claims that you hate children just like you do in your comments here, Ron?

Fritz said : "Ron, you examine the faulty statistics behind the Australian bike reduction numbers but accept without question the "60 - 80%" risk reduction rate noted by Ekman? Have you looked at the infamous Seattle study that the oft-quoted 88% number comes from? How about the more recent Austin study that made exactly the same mistakes in methodology?"

I scrolled up and read Ekman, and understand he left this comment out of his own choosing. I did not approve of a single statement from him. I did reply after his comment but the reply was infact to Rod Diaz, whose first name I got wrong and I mis-spelt as Rob. I apologize for the ambiguity. Again, I did not reply or approve of Ekman's comments.

How Ekman's "Even if a few lives can be saved with helmets, its a worth"? We have something like 16,000 head injury deaths every year in the United States from people inside of motor vehicles and tens of thousands more who become human vegetables, so where's your passion for protecting the children inside of the car? Even if a few lives can be saved, helmets on motorists and their passengers would be worthwhile, and 16,000 lives is more than few. These fatalities and injuries occur even with other advanced passenger protection inside the vehicle.If you tell me helmets for kids in cars is ridiculous, may I then insult you with ridiculously baseless ad hominem claims that you hate children just like you do in your comments here, Ron?

Again, you're digressing into vehicles like another reader and disturbing the topic at hand.

Look, I do not disagree that among the number one causes of TBI in children is motor vehicle crashes. I also do not disagree that these crashes can see upto 80 and above of g force to the head/brain, enough to cause injury. Given these facts, if you need to wear a helmet, or a neck frame, or a kevlar shield to your face, go ahead. I'm not going to stop you.

But before asking a party to wear helmets, it really helps to look at the root causes of these crashes.

http://enhs.umn.edu/current/6120/vehicle/vehicle.html

In 2004, alcohol use was a factor in 442 or twenty-one percent of fatalities due to crashes. Approximately half of those fatalities occurred to passengers in vehicles with a driver who had been drinking and had a BAC level of at least .01 (NHTSA, 2004).Other well known causes or contributing factors of motor vehicle crashes include excessive speed, distraction while driving, and drowsiness while driving.

Sadly, in motor vehicles accidents, children are rarely in the driver's seat. Its the negligence and ignorance of people who are that I CANNOT stand. If we need strict laws and legislation to protect children against negligent parents and motorists, so be it!

TAKE CARE OF THE ROOT CAUSES FIRST and prevent motor vehicle crashes! Our children can live.

Sadly, today we need laws to teach people to learn some things about safety. Thats not the law's fault. Its the people who have to blame. The number of injuries and fatalities from bicycle falls have gone so far for the state casualty wise and cost wise that we need a law to get people aware of their own safety. If it weren't for legislation, maybe we'd all kill ourselves due to our sheer ignorance and stupidity.

Now I throw the question back to you. If you can quietly follow booster seat laws or obediently strap your child with a seatbelt, not only because you care for him or her but you respect the law of the land, why can't you do the same and teach your child to wear a helmet while biking?

When someone has a strong opinion, and that person finds information that contradicts that strong opinion, can it be considered true that the contradictory opinion is wrong, or is it just that the person with the strong opinion isn’t being objective?

Ron starts his blog with a dedication to Andrew Callighan and finishes with a scenario that seems to closely resemble that of Andrews. So closely in fact that when Ron writes,

“you see your 12 year old kid, your own life and blood, walk out of the house with a bicycle…He's not wearing a helmet…a few hours later…local cops have some life changing news for you and your wife…Suddenly when your world was going all smoothly, someone in your family has become a statistic…What will your line of thinking be then?”

you have to wonder just how close this story is to Ron and if he can be objective about it.

I think we have to cut Ron some slack here if this is the case and consider he may not be examining the issue too clearly. If it’s not the case, Ron seems to be a little off base.

It’s clear how Ron feels about the protection a bicycle helmet can provide. He writes wearing a helmet increases your odds by a huge margin of preventing critical head injuries; that by choosing not to wear a helmet, you're taking a huge risk with your brain.

If one is objective on the issue, one can see that there are many qualified people who disagree and other who thinks that the issue is not so clear-cut.

I wonder who is spreading misinformation here? An armchair blogger, or an internationally recognized statistician working from an internationally accredited university?

Maybe we can all be better informed if we bone-up on some basics.

One of the leading experts on the mechanics of helmets, and director of Head Protection Evaluations (the principal UK test laboratory for helmets and head protection systems of all kinds), Brain Walker wrote an article "Heads Up" for Cycle Magazine, the bi-monthly journal of CTC, the UK's national cyclists' organisation. In it, he explains that the modern bicycle helmet was as a result of spin off technology from the improvement of motorcycle helmets. The protection provided was superior to the old leather hair-net style helmets and was easier and cheaper to produce. The impact protection was intended for riders who fall to the road without any other vehicles involved. That they should offer similar protection to pedestrians who trips and falls to the ground. He writes that they are the most fragile type of safety helmet and in road traffic accidents it’s not unlikely for a cycle helmet to be subjected to severity loads greater than it was designed to cope with.

The Department of Community Medicine out of the University College London produced a study on Pedal cyclists, crash helmets and risk. They write, most deaths and serious injuries to pedal cyclists are caused by other road users--principally motor vehicles. The large majority of pedal cyclist deaths are due to head injuries after collision with a motor vehicle. Helmets may protect against fall injuries, but current models are not designed to withstand the impact of collisions with motor vehicles. A public health policy towards reducing pedal cyclist deaths should seek prevention of accidents, rather than protection from their consequences.

“. . helmets will mitigate the effects of falling off your bicycle and striking your head . . . If a cyclist is accelerated by a car, then the helmet will not work and will not prevent a severe or even fatal injury.”

And even the founder of the Snell Memorial foundation has been quoted as saying,

“. . . it is impossible to build a helmet that will offer significant impact protection.”

This is all not to say a helmet is useless or doesn’t provide any protection. Of course it does. It just doesn’t offer the type of protection many (and it would seem Ron is in this group) think they do.

Lots (most) of head injuries to cyclists are superficial. This is where a helmet can help.

Where they often cannot help are the types of injuries that result from forces far too great for the helmet to withstand and those are the types of injuries that get recorded in population figures because these figures are much easier to collect in a robust manner (who needs to know about non-serious injuries?)

If helmets prevent a high proportion of cut heads but no serious injuries or deaths in crashes involving cars, for example, that would explain the disparity between the population-level figures and the prospective studies right away. It would also be consistent with the claims of the helmet manufacturers, which are much more modest than those of the campaigners, and with the published standards for helmets, which involve impacts equivalent to a very low speed crash or a fall from a stationary riding position.

All this makes perfect sense. The logical disconnect comes when you say "helmets prevent 85% of injuries, therefore they would prevent 85% of deaths". I don't think it requires particularly acute critical faculties to see the flaw in that chain of logic. You can call cuts and bruises lacerations and contusions, to make them sound worse, and you can lump everything from a cut ear to acute neurological trauma into one basket of "scary head injuries", but trivial injuries remain trivial; a device which protects against such injuries cannot without substantial additional evidence be assumed to prevent more serious consequences.

I’m sorry Andrew has been lost, but I think it would be best for everyone if we all looked for better and more effective methods to prevent this from happening again rather than chasing a red herring.

This blogpost, however, with its analysis and its conclusions does not really come as a surprise; considering your inclination to proudly declare cycling to rate among 'the most dangerous sports in the world' (actually, seven times, doing a google search for "most dangerous" on your blog).

No offence, but I cannot call you a good advocate for cycling.

BTW, just a thought; what if you began your post with an emotionally loaded article about a helmeted rider who suffered a fatal accident? Answer: the focus would have had to be on the cause of the accident, possible traffic insfrastructural analyses and or more stringent regulations for motor traffic. Now, wouldn't that kind of efforts be better both for cyclist safety and the number of cyclists? ...But then, safety in numbers also ranks as "statisulation" for you, your favourite statisticians and for Bell.

Have to mention though, that for the sake of cycling safety, your technical analyses of broken bicycles are just great.

(Don't make the mistake of replying by wishing me death and destruction by head injuries. Remember that your main focus was to tackle such things. Please.)

This blogpost, however, with its analysis and its conclusions does not really come as a surprise; considering your inclination to proudly declare cycling to rate among 'the most dangerous sports in the world' (actually, seven times, doing a google search for "most dangerous" on your blog).

Its not something I proudly do. You're mistaken. However, considering the risks of staying afloat on two thin wheels at 50mph, watching motor traffic at the same time keeping your line in a group ride, faulty equipment and defects that can quickly put anyone's life in danger and so on, I don't think I have made a hufge mistake in calling it one among hte dangerous sports. Nevertheless, its a great sport. Its a tough sport. This is part of the reason why major races all over the world are filled with so much drama. I'm surprised you don't think this deep about cycling. I'm not employing scare tactics to keep people away from cycling. In fact, I want to put a reality check on it.

If you think I'm employing scare tactics, explain why the manufacturers most intimate with cycling write instruction labels that classify cycling as an "inherently" dangerous sport and ask people to know the risks before committing to any course of action.

For the memory of Andrew, I think we should just stop arguing at this point. Look at the practical sides of helmets. I don't want to shush the people who say helmets are faulty as well. Faulty design and manufacturing I have seen plenty. I address them from time to time on this blog, hoping that someone would take a look at these incidents and rectify it from their end.

But to those who don't understand the "numbers game", who quote people and research work without knowing what they did and how they came to their conclusions, I call out that they need to do more homework. So do researchers, who often may not even ride a bike for that matter.

Considering your passionate description about the depth of the drama in cycling, you really seem to flirt with the idea of cycling being a death contempting pursuit.

explain why the manufacturers most intimate with cycling write instruction labels that classify cycling as an "inherently" dangerous sport and ask people to know the risks before committing to any course of action.

That is easy. It is really very much a USA-phenomenon: Litigations, companies do their best to avoid them. Remember the lawyer lips?

A relevant observation here is that practically any user manual for any bicycle or bicycle parts always list "wear a helmet" as the number one safety consideration.You wrote in a comment on this post: "TAKE CARE OF THE ROOT CAUSES FIRST". We can probably agree that the helmet should be demoted on that list.

I call out that they need to do more homework.

I have, and can easily detect a pattern: rather subjective interpretations of statistical data and generalisations (such as your own interpretation of the head injuries from the childrens body part injury table).

I believe that helmet research is in a unique position in this context. When you are trying to prove the effectiveness for, say, a new anti viral agent, you cannot publish data that cannot be strictly proven (Well you can but it has it's consequences...). When it comes to prove the dangers of cycling no such stringency applies, as no unwanted consequences exists... right?Well anyways, you don't normally expect scientists to use exclamation marks, with the exception for pro-helmet scientists, I've noticed.

You've had a previous post about "Odds of Dying in a Bicycle Crash", that quite contradicts your efforts in your last two posts, so let's just burry the axe.Most of us "sceptics" are only trying to divert an absolutism that have little scientific rigor.

Ron, after reading Robinson's research, your commentary and Robinson's response, it's my personal opinion that you're the one who is on the short side of the "numbers game" with Robinson.

Not that my opinion matters anymore than yours, but I really can't say yours is more valid than mine either.

As for Andrew, there's no argument about helmet use lain, just showing your use of Andrews case to elicit sympathy and emotion to futher your point. This is a poor use of argument because for as many Andrews as there are in the world, there are those who meet the same fate wearing a helmet. If we focuse n a red herring, the solution will not appear.

I wonder where you stand on the opinions of the other experts I've mentioned but I'm not sure it matters because you've shown your view point is not to be swayed from it's current position no matter what the evidence.

I think it will serve me and my readers well to point out that I made no comment anywhere that said Andrew would definitely live had he worn a helmet. Neither do I support helmet legislation.

Cycling is a fun and healthy sport but because of the environments people cycle in, it has inherent dangers. One could compare to refineries. Refineries are some of the safest places on earth these days. There is more chance that you get injured at home than in a refinery today. But does that make the work that these guys do any less dangerous? Its a dangerous job, but what you've done with safety laws, hard hats, gloves and safety glasses help bring down the injury risk, even though the inherent dangers in the job cannot be eliminated.

I guess I'm running after a dead horse, when I've stated many times that wearing helmets is but one in a multi-pronged approach to reducing critical injuries. I will not stand by the Australian research on bicycling reduction due to helmet laws. At best, I think several reasons and the exploration of alternative explanations are ignored by the researchers and the blame put on helmet law with some hodgebotch statistical models. Research with models is only as good as the models themselves.

At best, all this research is also outdated compared to today's times, when people recognize the validity of safety, helmet designs are getting better and certification processes are being improved and revised. But in the end, the Australian research into helmet law done back in the 90's still stand like a sore thumb, and even today people quote from it and spread information about it to interfere with safety and progress. I firmly believe this is largely to to ego, and nothing else. Of course, without a brain, there is no ego so these people might as well explore options to keep their head safe in a crash.

The bottomline is, however careful you are in cycling or regardless of the extent to which you cycle responsibly, there are factors that will lead to a crash and subsequent injury that you cannot control. It is best left to the discretion of the rider whether, at this time of peril, he should really dig into remote research articles that show how helmets don't work, or trust in the panacea and put on the second skull.

I for one will take doubt to those researchers who misplace correlations and causation.

I also hope helmet manufacturers take a second look at their designs and testing procedures, if that will allow any room for improvement over designs we have in the market today.

It is more correct to say that cycling, as well as any form of exercise for so much time every day reduces the risk of diseases and may add to lifespan, given that disease and external circumstance (like a fatal bicycle crash) don't interfere. Inherently, how long you live is determined more by genetics than anything else. The ability of a cell to divide diminishes over time until it is not able to do so at all. The abilities of the brain start decreasing after age 22.

Long term studies like the Harvard Alumni study of the 60's that have been done on athletes show how exercise has improved their lifespan but the research does not conclusively prove that any individual adopting similar lifestyles can add similar number of years to his or her life.

Most of what people believe and don't believe comes of out personal experience, as people can make out immediately how their quality of life increases in old age due to regular exercise. You also look and feel better.

The truth is, Andrew did not have a long life. Sadly his life was cut short and dreams were lost in a matter of seconds.

Bike_Boy, I guess that what you are aiming at is pretty much the same as some of Ron's arguments in his post. Which also is exactly along the same line as some of the latest publications from the "pro-helmet" scientists; to attack the questions raised by "helmet-sceptic" scientists, head on:

-Health benefits lost by less cycling-Safety in numbers-Risk compensation

It appears that the will of proving the effectiveness of the "panacea" appears to be really strong, for some reason. Seem to be somewhat unusual for scientific publications anyways.

While there are folks here who disagree that cycling has inherent risks, or claim that helmets are useless, the most practical of people I see are in those such as Donnie Miller, a certified bike safety instructor in Illinois. He competed in bike races and studied to become a safety instructor certified by the American League of Bicyclists. He is a consultant for the league and is safety and education director for the Quad Cities Bicycle Club. He also received training as a certified USA Cycling coach for competitive racers and still races at the master's level.

I'll refer everyone to this nice article where Donnie shows why cyclists should act like they command the lane of the road, how they should be aware and make others aware of their presence, obey rules of traffic and use common sense safety approaches such as wearing helmets.

Donnie is a great example of an individual who advocates a multi-pronged yet common sense approach to bicycling safety.

I wonder if the people who are quick to respond in the negative on this blog want to go challenge him on the practicality of helmets or the validity of his safety approach.

Here's a link for you from the CPSC. http://www.cpsc.gov/KIDS/crash.html

Bike accidents crash-land more kids in hospital emergency rooms than any other sport.

This is the same findings of the latest long terms studies on child fatalities in cycling as I wrote in this post http://cozybeehive.blogspot.com/2009/03/latest-research-bicycle-second-to.html

My intention has never been to "proudly" declare that cycling is dangerous. But looks like you're living in a fairy tale land of your own. You need to open your eyes. If you're an advocate for cycling, you'll also be an advocate for safety. I'm sorry to see that you're not.

Bike_Boy, most of what I've come to learn hasn't been from personal experience but from years of following studies that have shown, while bicycling can result in falls, the results of those falls are often minor injuries.

Mayer Hillman, a Senior Fellow Emeritus since 1992 at the Policy Studies Institute and has a doctoral thesis on transport, made a comparison of the life years lost in road accidents against the life years gained through improved fitness. He took each cycle death in 1989 and looked at the acturial evidence as to how long a person of a certain age could expect to live and multiplied that by the number of deaths in each age group in order to arrive at a figure of approximately 11,000 life years lost in cycle fatalities. To calculate life years gained he looked at some American evidence of the increased longevity of those who cycled regularly and this showed that people could expect to live two years longer. When this is multiplied by the numbers of those who cycle regularly, as revealed by the National Travel Survey, you arrive at the extraordinary ratio of 20:1. In other words, he says, for every life year lost through accidents, 20 years are gained through improved health and fitness.

Another example was a study done at Copenhagen University Hospital, Copenhagen, Denmark.

The title of the study was "All-Cause Mortality Associated With Physical Activity During Leisure Time, Work, Sports, and Cycling to Work" and can be found athttp://archinte.ama assn.org/cgi/content/abstract/160/11/1621

The study concluded, concluded:

"Even after adjustment for other risk factors, including leisure time physical activity, those who did not cycle to work experienced a 39% higher mortality rate than those who did."

A policy report on the health benefits of increasing levels of cycling in Oxfordshire -http://www.modalshift.org/reports/tandh/print_version.htm - showed one rough calculation suggesting that new cyclists covering short distances can reduce their risk of death (mainly due to the reduction of heart disease) by as much as 22 per cent.

So when someone suggests that to cycle is to take risks, my response would be that the greater risk would be to not cycle.

Brad, this is some kind of scare tactic. I don't believe in the nonsense that only cycling will keep you fit and decrease your mortality rate. Complete inactivity may. However, cycling is not the only leisure time sport around. Again, the paper you referenced came out of Cyclehelmets.org. Even on a whim, I don't think I'll be visiting that website any more.

Ron, your response is somewhat ironic. Your claim that cycling is dangerous is the scare tactic and to show the mortality of all of those who do cycle is lengthened over those who do not is the exact opposite of what you write. Cycling is in itself inherently healthy and to bury your head in the sand on the issue does no one any favors. That you do so is no surprise. It's clear you're buried neck deep already and have no inclination to dig yourself out anytime soon.

You're again diverting the topic here and misleading others. I did not think that cycling is NOT an inherently healthy activity. The topic I wanted to address in this post is : Why should cycling gain superiority over others, as a form of exercise (not transport)?

Not considering the deaths that occur in cycling...I'm sure that for an equal number of rsearch papers that address how cycling can extend one's year in life, there will be others that address how other exercises can also do the same.

Regular exercise, in whatever shape or form (provided it doesn't go into excess), reduces cortisol formation, gets ride of bodily toxins, increases the efficiency of the heart and lungs and keeps our brains healthy through improved cognitive functioning and positive hormone production.

I'm not burying my head in anything. You're needlessly stretching the issue and pouring sand over my head.

1) Decide for themselves whether they, and their family, wish to wear helmets, but be careful not to expect a helmet will save their lives. Cyclists who wouldn’t ride a route without a helmet, probably shouldn’t ride it wearing one.

Interesting. All this point, you were arguing about how helmet laws decrease cycling. Now you want to jump into the conclusion that helmets won't save lives. People have accused me of bias, but you have a bias to begin with. It is pretty clear that you don't like helmets, and NOT just helmet laws. It is "researchers" like you who give backbone to unsafe cycling practices. You do not appreciate helmets, the improvements in helmets happening these days, and the improvements in their design, testing and certification process. No doubt that safer roads and safer cycling practices can help reduce fatalities, but by shunning helmets, you aren't a good advocate for safety.

I take reservations to accepting your research. Please show us a research study that has been "longitudinally constructed", that show how cycling has decreased from the time of helmet law to now...are non-head injuries still decreasing today because a helmet law in the 1990's still influences that figure?

While you may be really impeccable in how you "collect" data, you have to be careful about drawing the wrong conclusions or misplacing causation and correlations.

The fact that most of you who are arguing with me are referring me to the same website, cyclehelmets.org, I have reason to reckon you all are from the same apple basket.

Ron, if you could come up with a pro-helmet study that is not outdated, that uses unpecable statistical models and - last but not least - contains unbiased correlations and causations... well, then you'd have a case.As it is now you just sound angry.

... the irony runs deep when Ron complains about Statisculation and engages in it.

Even in the related blog, Latest Research : Bicycles Second To Automobiles In Child Injuries, he engages in some pretty shoddy research that doesn't distinguish between minor or severe injuries.

I know there will be those who will side with Ron, but I think any reasonably intelligent person with a modicom of common sense and maybe a bit of experience can see Ron hasn't backed his opinions up very well and can pass over this blog without missing much of any value.

True, thus he would proably not be able to objectively judge the qualities of any pro-helmet paper either.Which I guess also would apply for myself (prolly also for Brad or for any other sceptic bastard).So at least, he could be consistent and strap on a high quality helmet on every car-trip (while remembering the oil-refinery simile).

I argued: cyclists should decide for themselves whether they, and their family, wish to wear helmets, but be careful not to expect a helmet will save their lives. Cyclists who wouldn’t ride a route without a helmet, probably shouldn’t ride it wearing one.

Ron relied: Interesting. All this point, you were arguing about how helmet laws decrease cycling. Now you want to jump into the conclusion that helmets won't save lives.

Ron, you have missed the point completely!!! Ever heard of risk compensation? There was a scientific study where children ran an obstacle course with and without a helmet and wrist guards. With them, risk-taking behaviour (falling, tripping and bumping into things) increased by 48-60%.

Remember the ski helmet website: “Dr Morrow was of the opinion that of 54 deaths at commercial ski areas in Vermont from 1979/80 to 1997/98, helmets would not have been of any particular value in saving any of the lives lost - as the degree of trauma simply overwhelmed any benefits that the helmet might convey in an impact. To quote Shealy et al again - a team of highly respected ski injury researchers - "On the basis of results to date, there is no clear evidence that helmets have been shown to be an effective means of reducing fatalities in alpine sports". It’s a sobering fact that more than half of the people involved in fatal accidents last season at ski areas in the USA were wearing helmets at the time of the incident (Source - NSAA). As Shealy states "[E]ven though the prevalence of helmet utilization is rising by 4 to 5 percent per year in the U.S., there has been no statistically significant observable effect on the incident of fatality."

The article implies that the proportion of skiers who die wearing helmets is greater than the population wearing rates. The same is true for bicycle helmets. Helmet-law enforcement has dropped off a bit, so wearing rates have fallen to perhaps 60%, compared to about 80% in fatally injured cyclists.

If the forces in all 54 ski fatalities were so great that helmets wouldn’t have saved lives, what chance is there if a helmeted cyclist is hit by a fast-moving truck? People who believe that helmets can save their lives seem to be more likely to ride on dangerous roads and so end up dead.

Ron: You do not appreciate helmets, the improvements in helmets happening these days, and the improvements in their design, testing and certification process. No doubt that safer roads and safer cycling practices can help reduce fatalities, but by shunning helmets, you aren't a good advocate for safety.

Expensive helmets have more ventilation than earlier models, but they are certified to the same standards and aren’t designed to cope with the impact forces in bike/motor vehicle crashes that cause the vast majority of seriously debilitating head injuries to cyclists.

The two most promising improvements in helmet design are the Conehead and the Phillips helmet, but they are available only for motorcyclists. The developer of the Conehead was inspired to develop a better helmet because he: “went out with the traffic investigation squad to understand the accidents and to retrieve the helmets. What he discovered was bone fragments, fluid and teeth embedded into the foam but the liners showed little or no evidence of damage.”

If you compare a group of helmeted kids who are learning to ride and have minor falls, with a group of non-helmeted ‘street-smart’ kids many of whom are hit by cars or trucks, the first group is bound to have a lower head injury rate than the second – cyclists in bike/motor vehicle crashes have about 5 times the head injury rate of bike only crashes. So the fact that the kids learning to ride were more likely to wear helmets and had a lower head injury rate doesn’t necessarily mean the difference has anything to do with helmet wearing, perhaps just that they wobbled and had a few minor bashes.

The statistical models I’ve seen fitted to such data to “prove” that helmets prevent 85% of head injuries have so many holes in them that, according to one numerate fellow cyclist, you could drive a truck through them. “Statisticulation” is not a bad way description.

Note also that for more serious crashes, under the logistic regression models fitted by the statisticulators, if 99% of non-helmeted and 96.8% of helmeted cyclists had brain injuries, the odds ratio is 0.31, which virtually everyone who promotes helmets or helmet-laws describes as “helmets prevent 69% brain injuries”. It’s a pity that more people don’t actually look at the data and perhaps even work out that the real difference is 99%-96.8% = 2.2%.

I’ve looked at many real-world datasets where helmet wearing increased dramatically when helmet laws were passed (average pre-law = 35%; average post-law = 84%), but I’ve yet to see any convincing evidence of corresponding reductions in head injuries, as percentage of total injuries to cyclists. If anything, head injuries seem to increase relative to the amount of cycling.

There’s no magic in looking at data. If helmets were anything like as effective as claimed, why didn’t we see an obvious response in percent head injuries when wearing rates increased from 35% to 84%? If it’s risk compensation, then my advice is perfectly sound – don’t believe that helmet will save your life, otherwise you’ll be tempted to ride on more dangerous roads and so end up dead.

The parents of the kid who died of a brain injury were devastated. His helmet didn’t save him, but a couple of no-parking bollards probably would have. It’s much better to ride without a helmet on a safe road than with a helmet on a more dangerous road. I’m sure we’d all be far safer if the police spent their time ticketing speeding and drunk drivers than non-helmeted cyclists.

So in summary, helmet wearers (like a good deal of other safety equipment) are better off if they believe that the helmet won’t save lives. Then they won’t be tempted to ride on more dangerous roads, and increase the chances of being hit by a carelessly driven motor vehicle.

Of the 220 or so plus fatalities in NYC during a 10 year study, only 3% of those who died wore helmets. The rest didn't wear them and head injuries contributed to three quarters of bicycle deaths.The NYC Department of Health and Hygiene has advised that the takeaway from this is that helmets save lives. I don't doubt it. Great job on this blog Ron.

'cmon Phil. Use your noggin. How many people in NYC wear a helmet? Is it surprising to find out in places where everybody wears helmets, those who die are wearing helmets and in places where they don't, they aren't?

The bullshit that's being purported by folks in support of Dr. Robinson's paper and who are against helmets is frustrating and plain ridiculous.

I didn't have time to go through all 90 comments but i picked up on bunch of them who mouthed out the same unintelligent thing over and over again, one among them being the question 'why do car drivers don't wear helmets, if bicylists have to ?' ... C'mon people, put things into perspective here. This is ridiculous.

A car has four wheels, seatbelts, airbags, a crumple zone and so much more momentum. Compare this to a two wheeled bicycle weighing some 20 pounds with skinnny tires and there's significantly lesser room for error to prevent a "fall". NASCAR and other auto racers deliberately put themselves in danger, because afterall, racing is all about adrenaline, speed and big money. These people recognize the need for safety because the worst injuries result in death. They wear helmets and have seatbelts, including 5 point restraining systems. Stock cars used in racing are not built safety wise like the automobiles we use to transport ourselves daily. When it comes to performance and big money, weight matters and advertising sponsors make the decisions. Lately, there have been numerous basal skull fractures received by drivers like Dale Earnhardt and Adam Petty. Doctors have determined that a helmet harness is a good protective measure to stop some of these injuries. A basal skull fracture can result fro a severe whipping forward motion and/or a sudden abrupt stop - as in Dale Earnhardt's case. A basal skull fracture almost always results in immediate death.

Asking the much more sane and normal motorists to wear helmets is as ridiculous as asking bicyclists to wear parachutes.

Most of the comments here also surround the supposed inability of a helmet to stop impact and its ability to prevent injuriy. This comes out of a misunderstanding of what a helmet does.

Without a helmet, hitting your head can transmit a thousand or more g's of acceleration to your brain in about two thousandths of a second as you come to a violent, very sudden stop on the hard, completely unyielding pavement. With a helmet between you and the pavement your stop is stretched out for about seven or eight thousandths of a second by the crushing of the helmet foam. That little bit of delay and stretching out of the energy pulse can make the difference between life and death or brain injury.

Other concerns from the folks here are that helmets almost always don't protect you against a collision with a motor vehicle.

In a report covering bicycling fatalities in NYC from 1995-2005, the NYC department of health in association with the NYPD concluded with the following :

This report describes bicyclist fatalities in New York City over a ten-year period, as well as bicyclist serious injuries for an 8-year period. Several key points emerge from the analysis. First, nearly all bicyclist deaths were the result of a collision with a motor vehicle. In particular, a high proportion of bicyclist fatalities were due to a crash with a large vehicle, such as a truck or a bus. Second, the vast majority of deaths occurred outside of bicycle lanes and other bicycle facilities. When a fatal bicycle crash with a motor vehicle occurred on a city street with a bicycle lane, the bicyclist was always outside of the lane itself, suggesting that dedicated bicycle paths or lanes may help reduce crashes with a motor vehicle. Third, human factors on the part of both motorists and bicyclists were the most common type of contributing factor for bicyclist deaths. For motor vehicle drivers, inattention was the most frequent cause of involvement in a fatal bicyclist crash. For bicyclists, disregarding traffic signs or signals at intersectionswas demonstrated to be particularly deadly. Fourth, most bicyclists who died had head injuries, and nearly all of the bicyclists killed were not wearing a helmet at the time of the crash. Head injuries may not have been the primary cause of death in all cases, but these findings do highlight the head as being particularly vulnerable to injury and a likely major cause of bicyclist fatalities. While the rate of helmet use among those bicyclists with serious injuries was low, it was six times higher than the rate among those bicyclists killed. These data suggest that helmet use is a critically important protection for all bicyclists. Fifth, nearly all bicyclists who died were male. While the majority of bicyclists in NYC may indeed be male, these findings suggest that theyare at greater risk for having a fatal accident.

Full report is here : http://www.nyc.gov/html/doh/downloads/pdf/episrv/episrv-bike-report.pdf

I'm sure researchers like Robinson will choose to conveniently ignore the good amounts of research done that show how helmets reduce the risk of head injury in a crash. This is shown by the bio-mechanical and epidemiological evidence reviewed in this paper (http://www.bhsi.org/henderso.htm). Scientific research has uncovered hard evidence on the benefits of bicycle helmet wearing, quite independent of issues related to the acceptability and effects of legislation.

While those studies showing that helmets reduce the risk of injury or death by 85% may be debatable and may even be exaggerated, he most careful, conservative estimates from good studies show that the reduction in risk of head injury to a bicyclist as a result of wearing a helmet is in the order of 45 per cent. In other words, at the very minimum a helmet halves the risk of head injury.

Old-style helmets that do not comply with the Australian Standard reduce the risk of head injury by little or nothing. Helmet designs and their testing standards have considerably improved from the days of yore, in which Dr. Robinson and her recalcitrant "no-helmet" peers seem to have deeply planted their feet in.

Even today, helmets that are misused and not worn properly can prematurely suffer failure or come off in a crash which could expose your head to serious injury. If you really want to argue that helmets are bad safety wise, investigate first if the helmets were WORN CORRECTLY and not misused in the first place, before shitting on helmets and being bad examples for people who are more safety conscious.

It is suffice to say the good news is that these recalcitrant people who are against helmets is quickly becoming a minority. I firmly believe that the vast majority of people who cycle today are concerned about their safety and are indeed wearing helmets, among other things such as learning how to ride safely. This is a big win for safety.

This is an excellent topic and I thank Ron for exposing the delusions that some people suffer from concerning helmets.

BB : Thanks for the time and effort in commenting. Helmets are far from perfect, so are helmet standards. But like you said, its clear that they have a significant effect on reducing fatal blows and tissue injuries in the brain. Heck, nothing is perfect out there. People complain about anything and everything. Helmets, seatbelts, airbags .. the list is endless.

It would be really interesting to interview Dr. Robinson and her friends to see if they buy cars with seatbelts and airbags at all, or do they buy one and still complain about their effectiveness, digging into spurious statistics when they could all shut their mouth and be practical and drive safely and DO WHAT'S RIGHT.

It is pretty clear to me that people fight "laws" that could be instrumental in spreading safer practices not because they know anything about helmets, more so because their ego and "personal freedom" gets invaded. Researchers will steadfastly support any of their own number crunching ofcourse...because that's what they were paid to do. Its interesting what they'd all think and how they experiences would change had any of them met with a real bicycle crash without a helmet. I doubt they would be here to tell the story...

Hey if that is arrogance, and if 'finding out the hard way' means one is being able to 'keep his brain', his sense of self, his responsibilities towards his job and family, all the while not burdening society to take care of folks with catastrophic head injuries, anyone should welcome that arrogance any day!

Excluding any unwanted discussions on the topic of helmet laws...I hope kids, if not the more rebellious of adults, learn the right things about bicycling safety and are taught about protective bicycling equipment, what they do, why they are important, whats in the market today and how thay must be worn to take "full advantage" of their protection. I don't think these young minds that are the pillars of tomorrow deserve the delusional garbage that "helmets are useless". Losing them is a far worser cost for a family, and for a society. Put that into perspective.

To All : Please stick to the topic and avoid beating about the bush. Any further use of language or attacking anyone personally, whether that be proponents or opponents of helmets will be deleted. We're having lots of one and two sentence comments here that are nothing but devoid of quality argument.

Byron : What is YOUR point of you. We want to hear it. You haven't even told us which side you're picking and why. :)

You're quick to fire off attacks on how others should show 'humility' and consume time henpecking for 'contradictory ignorance' and 'baseless arrogance'. But I'd say put aside the moral science lessons for now and bring something to the table. As far as this discussion is concerned, if there's anything baseless, its your comments so far.

Here's a video of young man jumping stairs on his bicycle. Head receives a full blown slam on the ground.

Another video of a biker doing the same thing, only this time the crash looked so much more severe. Head was hit and he seems to be bleeding from there, with what seems to be a slash just above his right eye.

Here's a clip showingvideos of kids and adults falling off bikes. Some are wearing helmets, some aren't but its obvious to see that you don't need to be hit always with a motor vehicle to crash. What may turn out to be a joke or playfulness could turn into something ugly.

Here's one of a huge track cycling pileup in Melbourne. A good percentage of those involved had their helmeted heads strike the banked floor. Crashes like this are so quick there's very little time to think or respond.

Injuries need not always involve the head. In this video, this child bicyclist got a handlebar brake lodged into his stomach.

Here's a Chinese bicyclist horribly injured in an accident. No helmet. Face sideways against the road.

Here's a video of a cyclist getting hit by a motor vehicle right in front of an officer. He is launched in the air, lands on the road in front of the car and slides a few feet before coming to rest.

Sometimes cyclists are a danger to themselves.This non-helmeted female cyclist puts her foot into the spokes of her front wheel on her jolly ride and gets launched off the front end of the bike, landing directly on her face.

Here's a helmeted mountain biker launching off a ramp and landing in a terrible way. He's breathing hard but later manages to laugh it off. Wonder if he'd done the same without the helmet. :)

Here's one where a tiny child wearing a helmet misjudges the speed during a right turn and crashes his head directly into a wall around his house. The mom is laughing and the kid apparently is laughing after the incident. Its plain obvious to see that the helmet came in the way of a more serious injury to the child.

Finally, here's another child cyclist without a helmet whose trike meets the curb bump and throws her off the bike, planting her head and face into the ground.

More videos such as these are out there on the internet, and sadly, they make laughter and entertainment for people. Such is the vile state of our internet age.

Kids learning to ride bikes can fall. Laughter can turn to tears even if that crash may look like a mere 'bump to the head'. Men and women using their bikes to commute and race can meet with an accident at any time. And bicycling is a wonderful and fun sport and transportation medium. Put all these facts together and you know you have to make a compromise somewhere if you have to enjoy bicycling for the rest of your life. If that means wearing a "lid" on your head, so be it. That may end up being a very important decision you make. It may even not. What was the probability that the decision you took was a good one? You'll soon find out :)

It seems like a reverse survivor bias takes prominence among the those who oppose helmets. But hardly anyone notices your typical mundane bicycling accidents involving a child riding around the house or park where a helmet came in the way and protected against the chances of more serious injury.

Ron said: “It would be really interesting to interview Dr. Robinson and her friends to see if they buy cars with seatbelts and airbags at all, or do they buy one and still complain about their effectiveness, digging into spurious statistics when they could all shut their mouth and be practical and drive safely and DO WHAT'S RIGHT.”

The last car I bought was in Jan 1990. It has seatbelts (which I wear whenever I use it) but only much more expensive (and fuel inefficient models) had airbags at the time.

I tried wearing my bike helmet in the car, in view of the research that “The total benefits associated with headwear in the form of a soft shell bicycle helmet were estimated to be … $476 per car equipped with airbags ($626 for cars without airbags) – see http://www.monash.edu.au/muarc/reports/atsb160.html

However, the helmet wasn’t particularly comfortable, so in view of the fact that I spend much more time on the bike than in the car, I don’t bother. I’ve seen the crash tests showing how often the heads of seatbelted dummies hit the windscreen, at forces severe enough to cause brain damage though moderate enough (thanks to the seatbelt) for the helmet to help. Even though it may be more sensible to wear a helmet in the car than on the bike, I spend a lot more time on the bike than in the car, so not wearing one in the car doesn't seem like a significant risk.

But, as I’ve said, I spend a lot more time cycling, so reduced safety in numbers because helmet laws discourage cycling is important to me.

There were at least 3 surveys where the equivalent of 42%, 52% and 64% of people who cycled actually said they had either given up or cycled less because of the helmet laws. Either all these people were telling lies, or helmet laws really do discourage people from cycling.

Our Council Bicycle Committee is trying to encourage cycling, so I continually hear about people who still tell me they don’t cycle because of helmet laws.

It’s silly to say that people who oppose helmet laws oppose helmets, or claim as Bike_boy does that “Helmet designs and their testing standards have considerably improved from the days of yore, in which Dr. Robinson and her recalcitrant "no-helmet" peers seem to have deeply planted their feet in.”

The change in helmet performance in the UK was described by Brian Walker, from helmet testing lab Head Protection Evaluations: “During the early 1990s there were helmets available in the UK for less than £10, which nevertheless offered extremely good performance. The helmets were manufactured to the Snell B-90S standard, were fashionably stylish, were not heavier than the norm, were well ventilated, and had a comfort factor on a par with other makes. None of these helmets is available today. Cycle helmets sold in the UK today generally offer a lower level of protection than those sold in the early 1990s."

Despite all helmets sold here supposedly satisfying Australian standards, my impression is that our trends were along the same lines. I know that some of the older helmets were safer than the ones currently on sale.

When the Australian standard was up for review in 2008, I sent in a submission arguing for a sliding impact test (now common for motorbike helmets) to reduce the risk of rotational injury and a ‘star’ rating to show which helmets are best at attenuating accelerations. New designs such as the conehead obviously provide far superior impact protection for no extra weight than the models currently on sale, and the Phillips helmet is much more likely to prevent brain damage from rotational injuries. A star rating for helmets would allow consumers to be informed about the superior protection of these helmets, which might be enough to create a market for them, instead of being available only for motorcyclists.

Doing the right thing means checking the facts and actually looking at the data. Helmet laws created a unique dataset where, in 5 different jurisdictions at 5 different dates between 1990 and 1994, helmet wearing increased dramatically (average pre-law = 35%; average post-law = 84%) within a few months. Very few argue that they can see a change in the head injury rate corresponding to this massive increase in helmet wearing by many millions of cyclists. Almost equally few argue that cycling became safer – in all cases the injury rate per cyclist appears to be higher than would have been expected without the laws.

Apart from the ones that gave up, you are essentially comparing the same group of cyclists under the same conditions, the main difference being that they were mostly unhelmeted pre-law and helmeted post-law.

This should provide a more realistic idea of the benefits of helmet wearing than comparing a group of generally safety conscious cyclists who chose to wear helmets with another group that did not - there are usually so many differences between the groups that it’s almost impossible to decide what might be due to helmets and what to the other differences.

Safety in Numbers is important. We used to be a cyclist-friendly town so, sadly, census data on cycling to work show a bigger reduction here than elsewhere.

After 37 years of cycling almost every day without needing hospital treatment, my luck gave out on November 4 (long after I wrote the paper on safety in numbers) when a vehicle driver came out of a stop sign without looking for cyclists. I was off the bike for 2 months and am still receiving physiotherapy.

More cyclists = safer cycling = fewer head injuries per cyclist. Arguing that we should coerce cyclists into either wearing helmets or finding alternative means of transport (with the result you have seen in the injury statistics) seems very strange behaviour for anyone who cares about cycling.

Far better to let cyclists (or in the case of children their parents or guardians) weigh up the risks and decide for themselves.

Dr. D.L : Arguing that we should coerce cyclists into either wearing helmets or finding alternative means of transport (with the result you have seen in the injury statistics) seems very strange behaviour for anyone who cares about cycling.

As far as I remember, I went through every single comment here and no one supports forcing anyone to wear helmets. We're calling for common sense. I guess we can safely end this discussion, since you can't compromise with common sense safety practices and I can't compromise with your regretful choices of action. Its interesting that you say kids should decide for themselves whether helmets are appropriate for them or not. Rather than having an experienced person advising them to do, I guess it will take a young prodigy to make that decision. Btw, did you see any of the videos posted by C. Taylor? Do take a look, as sometimes one needs humanity more than a debilitating analytic brain.

Hope you get well and get back on the bike. I'm watching the Paris-Roubaix now. Can't imagine what those guys would do without helmets. :)

I'd imagine they'd do just as well as they had for all those years they didn't have them.

I think it's a fine thing Ron is giving up because as I have seen, there's no disuading him from his opinion.

That's as it will be, there are always going to be disagreements but after the issue has been kicked around for over 20 years one would think that if there was a definitive benefit to wearing helmets while riding bicycles, most people would wear them. That there are still only a minority of people who choose to wear helmets speaks volumes about what people think of them

Brad, this certainly isn't about winning or losing, because as long as we sit here and argue, there are people out there who're dying every year from head injuries. Just look up the statistics from the FARS (http://www-fars.nhtsa.dot.gov/People/PeoplePedalcyclists.aspx)

Further, you accused me of spreading the fear that bicycling is inherently dangerous and has risks associated with it. But that wasn't just me saying it. For instance, the CPSC said it once , and estimated ER treatments was highest for cycling than any other sport or recreation in 2004. http://www.cpsc.gov/cpscpub/pubs/cpsr_nws40.pdf

You also labeled the paper "Bicycle Related Injuries Among Children And Adolescents In The United States" authored by professionals from the Nationwide Children's Hospital Research Institute as "shoddy". That was really interesting, since you provided zero facts and proof for this bold claim that the paper was just "bogus". If 16+ years of research is bogus, you definitely need to show it, which you didn't.That shows lack of professionalism right there. Infact, you're ready to ignore any evidence that runs counter to your beliefs.

What that paper by the Nationwide Children's Hospital run along the same lines of whats being shown by various other medical groups in the U.S...that more and more children are being treated in ER for head injuries in bicycling. You defy logic when you oppose research papers like this, yet you ridicule me for blaspheming against Robinson's paper. Not good, Brad.

Lastly, from the beginning, I noted you as being a vocal supporter of Robinson's research paper...which was fine since it was arguing against helmet laws and I am against forcing people to wear helmets. But it started getting cloudier from there. I thought you respect things like "personal freedom" for people to decide YES or NO for helmets, I guess you defied your own principles by persuading others reading this that helmets are completely useless, and this you concluded not from any personal experience, but by sitting in your armchair somewhere studying some paper from here and there... I guess for some, it takes an experience or an incident to put perspective into things. You have lost perspective. For you, death is simply a number on paper, and you like to play some weird board game with it.

Believing helmets don't protect you is one thing, and persuading others to drop it is another. You do both. You are your own enemy, and you defy logic. I and others would like to advice you not to run any more safety "campaigns" for children. You're in some ways a danger to yourself and to children.